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Online ISSN 1827-1766
Institute of General Surgery and Surgical Specialties, Phlebo-lymphologic Centre, University of Siena, Siena
BACKGROUND: The aim of this study was to investigate the allografts efficacy in the leg ulcers treatment with various etiopathogenesis.
METHODS: From April 2000 to July 2002, 99 patients were randomly selected, 65 women and 34 men with mean age of 70.7 years. About the total 161 ulcers, 33 had venous etiopathogenesis, 21 arterial, 50 mixed, 12 diabetic, 27 traumatic, 5 post-thrombophlebitic syndrome (SPTF) of deep venous system, 1 dysplastic, 3 neoplastic, 5 neurological, 3 iatrogenic and 1 depending on scleroderma. Homologous skin grafting ware performed after surgical debridement under local anaesthesia. About 356 allograft performed, 144 times with de-epidermized derma (DED), 180 with thin glycerolised skin, 29 with thin cryoconserved skin, 3 with thigh glycerolised skin. Autologous skin grafting were performed in 13 patients. Eight times we try to use mixed meshgraft according to Alexander’s technique.
RESULTS: Seventy-two of 161 treated ulcers underwent to healing (44.7%) and 25 (15.5%) dropped out. Sixty-four ulcers (39.8%) are still in treatment : 4 are in closure, 41 presented a clear improvement, 14 didn’t present any advantage, and in 5 the management was starting now. Ulcers pain disappeared in 95% of the cases. Graft infection appeared in only 9 cases (2.5%). No evidence of host reaction were registered.
CONCLUSIONS: Allograft skin demonstrated to be very efficacy in different etiopathogenetic ulcers.