While most clinicians would not treat all venous ulcers with skin grafts, patients who have wounds recalcitrant to compression therapy could be considered for skin grafts as an adjunct to improve their likelihood of healing. Of the available skin grafting methods, the use of artificial skin appears to be the most promising, conferring a 29% increase in the likelihood of healing by 24 weeks and an increased rate of healing. These results are based on a randomised controlled trial in patients with recalcitrant venous ulcers.17 However, the significant costs associated with this therapy, as well as the theoretical risk of viral infection and the existence of only a single trial supporting its use, means that clinicians need to think carefully before treating patients with artificial skin.
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