Chronic leg ulcers in a patient with combined arterial and venous disease successfully treated with a human skin equivalent: A case report

Chronic leg ulcers are a common cause of morbidity and remain difficult to treat. Regardless of the etiology of chronic wounds, if conservative therap y fails and healing does not occur, other measures such as the use of skin grafts are indicated.(1) A new FDA-approved bioengineered skin substitute h as become available For the treatment of venous ulcers. This human skin equ ivalent is a living allogeneic cultured bilayer containing both epidermal a nd dermal components. The cellular components, human keratinocytes and derm al fibroblasts, are derived From neonatal foreskin, while the dermal matrix , type-1 collagen, is bovine in origin.(2) It has been transplanted without adverse immune responses in animals and humans.(3-5) The human skin equiva lent used in this case report is approved for the treatment of venous leg u lcers, and has been studied in human acute wounds as well.(4-5) We describe a patient with mixed arterial and venous disease and chronic ulceration of the lower extremity that responded to treatment with this human skin equiv alent.