Treatment of nonhealing ulcers with allografts

Chronic wounds often represent a significant medical and economic challenge. Clinicians seek novel therapies poised to foster production of granulation tissue and subsequent healing. Cadaveric allograft remains the mainstay in burn therapy. Research, however, shows that this treatment functions adjunctively in complex nonhealing wounds by manipulating the microenvironment, preventing desiccation of underlying bone and tendon, augmenting wound-bed preparation, and producing rapid closure. The following review presents the rationale for incorporating skin allografts into the wound healing algorithm, including chronic wound biochemistry, wound-bed preparation, current applications, combination therapies, cost considerations, and case studies. Diagnosis and treatment of underlying etiologies remains essential. A multidisciplinary approach using accepted treatment protocols helps reduce morbidity and expense associated with these lesions.