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Article
August 11, 1956

SKIN GRAFTS FOR CHRONIC WOUNDS OF THE LOWER EXTREMITY

JAMA. 1956;161(15):1462-1465. doi:10.1001/jama.1956.02970150030007
Abstract

• The usefulness of skin grafting in ending the pain and disability of long-standing ulcerations in the lower extremity is illustrated by four case histories. In one, the chronic open ulceration behind the knee was secondary to a burn sustained 20 years before; in another, ulceration on the dorsum of a foot had persisted for eight years after a laceration. In a third, a split-thickness skin graft failed before, but succeeded after, excision of an infected, fibrotic, calcareous mass of tissue that underlay a persistent, painful ulceration over one ankle. In the fourth, skin g-afting succeeded without excision after clearing up an infection that had led to skin necrosis.

The thin epithelium that ordinarily covers rigid scar tissue is vulnerable to relatively minor trauma. The resilient layer of normal skin is the dermal pad, and this, if grafted, may give longer and better function than does the epithelium alone. But successful grafting depends on careful attention to details.

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