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Research Article| Volume 40, ISSUE 1, P68-72, January 1987

Layered shaving of venous leg ulcers

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      Abstract

      A method for the quick preparation of refractory venous ulcer beds for autografting is described. Irrespective of their clinical or bacteriological state, ulcer granulations and other products of frustrated healing are shaved in layers down to an even and surgically clean base using an ordinary skin grafting knife. Our experience with 32 consecutive patients (58 ulcers) is reported. The mean duration of hospital stay, the patient being completely healed on discharge, was 18.3 days. This represents a decrease of more than 3 weeks when compared to a previously used standard method. No investigation into the question of recurrence was carried out as available evidence, which is critically reviewed, indicates no significant relation between the method of grafting and the incidence of recurrence.

      Reference

        • Arenander E.
        Varicosity and ulceration of the lower limb.
        Acta Chirurgica Scandinavica. 1956; 112: 135
        • Bauer G.J.
        The aetiology of leg ulcers and their treatment by resection of the popliteal veins.
        Journal Internationale de Chirurgie. 1948; 8: 937
        • Bergan J.J.
        • Flinn W.R.
        • Yao J.S.T.
        Venous reconstructive surgery.
        Surgical Clinics of North America. 1982; 62: 399
        • Brown J.B.
        • Byars L.T.
        • Blair V.P.
        A study of ulcerations of the lower extremity and their repair with thick split skin grafts.
        Surgery Gynecology and Obstetrics. 1936; 63: 331
        • Browse N.L.
        Venous ulceration.
        British Medical Journal. 1983; 286: 1920
        • Burgos H.
        Angiogenic and growth factors in human amnio-chorion and placenta.
        European Journal of Clinical Investigation. 1983; 13: 289
        • Burnard K.
        • Lea Thomas M.
        • O'Donnell T.
        • Browse N.L.
        Relation between post-phlebetic changes in the deep veins and results of surgical treatment of venous ulcers.
        Lancet. 1976; 1: 936
        • Elek S.D.
        Experimental staphylococcal infections in the skin of man.
        Annals of New York Academy of Science. 1956; 65: 85
        • Frank D.H.
        • Robson M.C.
        • Heggers J.P.
        Evaluation of Debrisan as a treatment for leg ulcers.
        Annals of Plastic Surgery. 1979; 3: 395
        • Hackett M.E.J.
        Preparation, storage and use of homograft.
        British Journal of Hospital Medicine. 1975; 13: 272
        • Homans J.
        The etiology and treatment of varicose ulcers of the leg.
        Surgery Gynecology and Obstetrics. 1917; 24: 300
        • Hynes W.
        Shaving in plastic surgery with special reference to the treatment of chronic radiodermatitis.
        British Journal of Plastic Surgery. 1959; 12: 43
        • Janzekovic Z.
        A new concept in the early excision and immediate grafting of burns.
        Journal of Trauma. 1970; 10: 1103
        • Linton R.R.
        The post-thrombotic ulceration of the lower extremity: its etiology and surgical treatment.
        Annals of Surgery. 1953; 138: 415
        • Matthews R.N.
        • Bennett J.
        • Faulk W.P.
        Wound healing using amniotic membranes.
        British Journal of Plastic Surgery. 1981; 34: 76
        • Ochsner Jr., A.
        Importance of recognising arterial insufficiency in post-phlebetic ulcers.
        Transactions of the Southern Surgical Association. 1962; 74: 246
        • O'Donoghue M.E.
        • Zarem H.A.
        Stimulation of neovascularization—comparative efficacy of fresh and preserved skin grafts.
        Plastic and Reconstructive Surgery. 1971; 48: 474
        • Peacock Jr., E.E.
        • Van Winkle Jr., W.
        Surgery and Biology of Wound Repair.
        W. B. Saunders Co.,, Philadelphia, London, Toronto1970
        • Ponte´n B.
        Plastic surgery treatment of chronic venous ulcers of the leg.
        Scandinavian Journal of Plastic and Reconstructive Surgery. 1972; 6: 74
        • Robson M.C.
        • Heggers J.P.
        Quantitative bacteriology and inflammatory mediators in soft tissue.
        in: Hunt T.K. Heppenstall R.B. Pines E. Rovee D. Soft and Hard Tissue Repair: Biological and Clinical Aspects. Praeger Scientific, New York1984
        • Rundle J.S.H.
        • Cameron S.H.
        • Ruckley C.V.
        New porcine dermis dressing for varicose and traumatic leg ulcers.
        British Medical Journal. 1976; II: 216
        • Teh B.T.
        Why do skin grafts fail?.
        Plastic and Reconstructive Surgery. 1979; 63: 323
        • Thompson N.
        • Ell P.J.
        Dermal overgrafting in the treatment of venous stasis ulcers.
        Plastic and Reconstructive Surgery. 1974; 54: 290
        • Trier W.C.
        • Peacock Jr., E.E.
        • Madden J.W.
        Studies on the effectiveness of surgical management of chronic leg ulcers.
        Plastic and Reconstructive Surgery. 1970; 45: 20
        • Ward D.J.
        • Bennett J.P.
        The long term results of the use of amnion in the treatment of leg ulcers.
        British Journal of Plastic Surgery. 1984; 37: 191