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A Journal on Phlebology

Official Journal of the Italian College of Phlebology
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Acta Phlebologica 2002 August;3(2):95-100

language: English

Treatment of leg ­ulcers ­with allo­graft ­skin

Mancini S.

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.

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