Treatment of skin ulcers with cultured epidermal allografts

Thirty-six skin ulcers in 23 patients were treated with cultured allogeneic epidermal sheets derived from neonatal foreskin. In 73% of ulcers, there was complete healing within 8 weeks, with a mean healing time of 3.3 weeks. In the other 27%, there was reduction in ulcer size of 35% to 93% by 8 weeks after grafting. In 30 painful ulcers, pain was markedly relieved within 24 hours of grafting. The healing pattern suggested that the cultured epidermal sheets acted by stimulation of host keratinocytes to divide and migrate rather than by permanent acceptance of the allograft. Of the 26 ulcers that healed within 8 weeks, 23 (88.5%) remained healed for follow-up periods of 10 to 18 months (mean 13.7 months), with an overall mean duration of healing of 13 months.