ORIGINAL ARTICLES   

Acta Vulnologica 2003 August;1(1):37-42

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: Italian

Treatment of hard-to-heal vascular ulcers by mean of allograft

Mosti G., Mattaliano V., Iabichella M. L., Picerni P.

Reparto di Angiologia e Cardiologia, Clinica MD Barbantini, Lucca

AIM: Vascular ­ulcers non-respon­sive to pre­vi­ous­ly ­proved effec­tive­ness treat­ment (­moist dress­ings, elas­tic band­age, walk­ing) can be sub­mit­ted to ­skin ­graft. Recently, allo­grafts, so far restrict­ed to ­burn ­care, are ­used in vas­cu­lar refrac­to­ry ­ulcers. Personal expe­ri­ence in the treat­ment of “­hard-to-­heal” ­ulcers ­with allo­graft is report­ed.
METHODS: A ­total of 100 ­patients (30 ­males; 70 ­females) age 75.7±10.6 ­years ­with 271 vas­cu­lar ­ulcers ­were treat­ed; ­ulcers ­area was 154.2±192.5 cm2 (­from 1 to 1000); ­ulcer dura­tion was ­months 31±55.7 (­from 1 to 300) and ­were resist­ant to pre­vi­ous ­good med­i­cal treat­ment. Graft was repeat­ed in 47 ­patients so ­that 194 pro­ce­dures ­were per­formed; in 180 cas­es ­cryo-pre­served in 14 cas­es gly­cer­o­late pre­served ­skin was graft­ed.
RESULTS: During the fol­low-up, 57 ­patients ­healed in 114.2±69 ­days; out of 43 ­patients non-­healed, 36 ­improved, 5 ­remained ­unchanged, 2 wors­ened; ­pain dis­ap­peared in 76 ­patients, ­reduced in 22 and ­unchanged in 2; exu­date ­ceased in 56 ­patients, ­reduced in 43, ­unchanged in 1. Local infec­tion was ­observed in 1 ­case.
CONCLUSION: Allograft is effec­tive in pro­mot­ing heal­ing or improve­ment of vas­cu­lar ­ulcers; it is ­also effec­tive in ­pain and exu­date con­trol; ­last but not ­least ­this treat­ment is ­safe and not expen­sive.