LONG-TERM ASSESSMENT OF CHRONIC LEG ULCER TREATMENT BY AUTOLOGOUS SKIN-GRAFTS

Background: Chronic leg ulcers (CLU) are a commun and major cause of m orbidity. For this reason, we systematically perform autologous skin g rafting. Objective: Long-term evaluation of this treatment. Patients a nd Methods: Among the 521 out-patients or those hospitalized for CLU b etween 1981 and 1993, we assessed 188 (118 women, 70 men, mean age 74 years, 144 grafts, 44 non-grafted). Results: For the grafted CLU, ther e were 46 failures (17.5%), 152 (58%) healed in a mean time of 2.2 mon ths and 64 relapsed (24.5%). For the non-grafted CLU, 3 did not heal ( 3%), 20 relapsed (22.5%) and 66 healed (74.5%) in a mean time of 4.7 m onths. All the patients who suffered from painful CLU mentioned a regr ession of pain after the graft. Finally, 87.5% of patients declared th at they would accept a new graft. Conclusions: We did not note any rea l difference in closure and recurrence rates between grafted and non-g rafted ulcers. This is most likely due to an important selection bias related to the methodology of our study. The grafted ulcers were more serious: they were larger (28.9 against 7.9 cm(2)) and older (11.1 aga inst 5.6 months).