While autologous skin grafts are occasionally used in some centres to aid the closure of recalcitrant wounds, the difficulties associated with harvesting the donor graft, as well as the complexities associated with inducing closure of the grafted site (in addition to the donor site), mean that this procedure cannot be undertaken lightly. Similarly, use of autologous cultured keratinocytes is a time-consuming, expensive and complex process that demands multiple patient visits and a laboratory capable of culturing the autologous keratinocytes.

Artificial skin for the treatment of venous ulcers is not in widespread use. This may because of the substantial cost involved. This concern has been addressed in an economics study.18

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