[The role of skin transplantation in the treatment plan of venous (post-thrombotic) varicose ulcer].

Under both inpatient and outpatient conditions several skin grafting techniques (eg. split-skin meshgraft, postage stampgrafts) can be useful in treating already phlebosurgically operated venous ulcers. 82 already phlebosurgically longterm treated venous ulcers were skin grafted under clinical conditions in the time from 1983 to 1992. Various characteristics of this patient-group (eg. age, sex, duration of disease, localization and size of venous ulcer) were put retrospectively into comparison with those of 72 patients suffering from venous ulcers treated exclusively in a conservative manner. Patients of the skin grafted group - aged mostly 55 to 65 years - suffered longer from chronic venous ulcers, of which 15 were circulatory. The time interval between clinical admission and skin grafting (16th to 28th day), the index of healing dependent indicator for the dermato-surgical intervention, as well as short and long term results, were investigated. In contrast to favourable short term results (39 patients with complete, 17 with > 50% settlement of skin graft) long term results were rather disappointing. 27 of 39 operated patients with initially successfully treated venous ulcers answered a questionnaire in which, as a result, only 15 did not suffer a relapse one to nine years after the dermatosurgical intervention. Despite of these results, simple techniques of skin grafting will still be in future of great value.