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. 2017 Dec;14(6):1213-1218.
doi: 10.1111/iwj.12787. Epub 2017 Oct 27.

Use of epidermal skin grafts in chronic wounds: a case series

Peter Am Everts  1 , Marco Warbout  1 , Diana de Veth  1 , Merel Cirkel  1 , Nicole E Spruijt  1 , Jaap Buth  1
Affiliations

Use of epidermal skin grafts in chronic wounds: a case series

Peter Am Everts et al. Int Wound J. 2017 Dec.

Abstract

In stalled, chronic wounds, more aggressive and proactive wound closure efforts are needed. We describe adjunctive use of epidermal grafting in patients with chronic wounds. Wound bed preparation consisted of surgical necrotectomy or sharp debridement, hyperbaric oxygen therapy, negative pressure wound therapy, compression therapy, platelet-rich plasma therapy and/or heparan sulphate agents. Epidermal grafts were harvested from the patient's thigh and applied to the wound. Wound and donor site healing was monitored. A total of 78 patients (average age = 64·1 ± 15·6 years) were included in the study. Common comorbidities included hypertension (47·4%), venous insufficiency (37·2%) and obesity (28·2%). Average wound duration was 13·2 months (range: 0·3-180 months). The most common wound types were dehiscence (29·5%), radiation ulcer (24·4%) and venous ulcer (17·9%). Total time from epidermal grafting to wound closure was 10·0 ± 7·3 weeks. Of the 78 wounds, 66 (84·6%) reached full wound closure (49 < 3 months, 16 > 3 months, 1 without time data). Of 78 wounds, 10 (12·8%) underwent partial wound healing, while 2 wounds (2/78; 2·6%) remained unhealed. These results suggest that wound surface reduction can be achieved by proactive early application of biological therapies and epidermal skin grafts, which may help decrease time to wound healing.

Keywords: Chronic wounds; Epidermal grafting; Wound care.

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Figures

Figure 1
Figure 1
Chronic recurring skin infection on right foot with osteomyelitis. (A) Wound at presentation. (B) Wound after multiple debridements. (C) Wound fully healed 3 weeks post‐grafting.
Figure 2
Figure 2
Case 1 donor site post‐graft harvesting. (A) Donor site immediately after graft harvesting. (B) Donor site 1 week post‐graft harvesting. (C) Donor site fully healed 2 weeks post‐graft harvesting.
Figure 3
Figure 3
Wound after breast reconstruction post‐radiation therapy. (A) Wound at presentation. (B) Wound 2 weeks post‐grafting. (C) Wound fully healed 6 weeks post‐grafting. (D) Donor site 1 week post‐graft harvesting. (E) Donor site fully healed 2 weeks post‐graft harvesting.
See this image and copyright information in PMC

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