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Cultured epidermal grafts in the treatment of leg ulcers.

Cultured epidermal grafts offer a major advance in the treatment of burns and other disabling skin wounds in which there are few other available treatments. Cultured allografts offer immediate availability, obviating skin biopsies. Theoretically, they could be grown in advance, cryopreserved, and stored in skin banks. They provide rapid coverage of wounds and produce prompt relief of pain and healing that continues for many weeks after the graft has been applied. Their mechanism of action has not been elucidated, but it seems likely that the allografted cells do not survive permanently and are gradually replaced by host epithelial cells. Release of growth factors by cultured allografts may contribute significantly to their wound healing properties. Whatever their mechanism of action, they promote rapid epithelialization at least in small chronic wounds. Especially for the elderly patient with nonhealing ulcers, they offer an alternative treatment option that is simple, painless, and noninvasive.