Circular crural ulcer; its surgical therapy

Experience with the surgical therapy of two serious cases of crural ulcer is described. The ulcers were widely and deeply excised together with the fascia and covered three weeks later by a split free skin graft. As a technical innovation, a mesh graft was applied in one case and in the other the ulcer was removed in two steps to avoid secondary shrinking. The functional result was in both cases unobjectionable even two years after the operation. In similar, apparently hopeless, cases the method will help to avoid amputation and to achieve complete freedom from symptoms for years.