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To the Editor:—
The article on the gold-leaf treatment of skin ulcers (196:693, 1966) disturbs me a great deal. I fear that physicians reading this article will draw the conclusions that (1) this represents conservative therapy and (2) the results are good. In point of fact, if conservatism is defined as that treatment most likely to produce the best result in the shortest time with the least morbidity, then the treatment outlined in this article is radical, and the results are poor. For example, in two illustrations showing "healed" lesions, the covering was scar epithelium which will undoubtedly break down again at the slightest provocation. In another illustration of a stasis ulcer of the ankle, the wound was far from healed after one month of therapy. As a plastic surgeon, I would be disappointed if surgical excision and skin grafting did not produce 100% coverage of the entire area
Dykes ER. Gold-Leaf Treatment of Skin Ulcers. JAMA. 1966;197(6):515. doi:10.1001/jama.1966.03110060189037