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Impact of Skin Grafting of Venous Leg Ulcers on Functional Status and Pain

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Abstract

Background

Disability and pain were assessed in patients with venous leg ulcers treated with split-thickness skin grafts to evaluate to what extent skin grafting improves functional status in this population.

Methods

A prospective, nonrandomized, multicenter case–control study was conducted from July 2008 to December 2010 in two hospitals in Brazil. One hundred patients with venous leg ulcers were divided into two treatment groups of 50 patients each: the control group (conservative treatment) and the surgery group (skin grafting). Patients were assessed at baseline (day 0) and on days 30, 90, and 180. Disability was measured with the Disability Index of the Health Assessment Questionnaire (HAQ-DI). The visual analog scale (VAS) and McGill Pain Questionnaire (MPQ) were used to assess pain.

Results

Surgery group patients reported significantly lower (p = 0.0001) overall HAQ-DI scores (lower disability levels) 180 days postoperatively (HAQ-DI = 0.18) compared with baseline (HAQ-DI = 2.65); mean overall HAQ-DI scores for control patients was 1.70 on day 180, with a significant difference between groups (p = 0.0001). The surgery group showed significant improvement on all HAQ-DI categories and reported significantly lower pain intensity (VAS pain scores) on days 30, 90, and 180 compared with controls (p = 0.0001). The MPQ was used to assess the sensory, affective, evaluative, and miscellaneous dimensions of pain in the two groups; there were significant differences between groups on days 30, 90, and 180 (p = 0.0001).

Conclusions

Patients with venous leg ulcers treated with split-thickness skin grafts showed improvement in functional status compared with controls.

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Conflict of interest

There was no external funding for this study. The authors have no conflict of interest, financial interest, or commercial association with any of the subject matter or products mentioned in the manuscript.

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Authors and Affiliations

  1. Department of Surgery, Sapucaí Valley University (UNIVÁS), Pouso Alegre, MG, Brazil

    Geraldo Magela Salomé

  2. Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil

    Lydia M. Ferreira

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  1. Geraldo Magela Salomé
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  2. Lydia M. Ferreira
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Correspondence to Geraldo Magela Salomé.

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Salomé, G.M., Ferreira, L.M. Impact of Skin Grafting of Venous Leg Ulcers on Functional Status and Pain. World J Surg 37, 1438–1445 (2013). https://doi.org/10.1007/s00268-013-1975-z

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