Cultured epithelial allografting of leg ulcers

Abstract

Fifty-two venous ulcers, with a mean duration of 12 years, were treated with cultured epithelial allografts. 43% of ulcers were completely healed between 7 and 28 days after the procedure, with the remaining lesions reduced by 45% of their original area. Identification of the cells of origin in a culture-grafted ulcer remains elusive. Clinically there was no convincing evidence of graft ‘take’, healing clearly progressing inwards from the ulcer edge. It seems likely that this healing reflects a biological effect rather than graft survival. Despite being unable to provide evidence of incorporation of donor cells, the beneficial effect of the epithelial allografts is clear, two-thirds of these ulcers had a ‘control’ period of conventional treatment with only minimal healing occurring. The patients in this study were treated as inpatients but the procedure could easily be carried out in the outpatient dept.