Chronic Leg Ulcers in a Patient with Combined Arterial and Venous Disease Successfully Treated with a Human Skin Equivalent: A Case Report

Chronic leg ulcers are a common cause of morbidity and remain difficult to treat. Regardless of the etiology of chronic wounds, if conservative therapy fails and healing does not occur, other measures such as the use of skin grafts are indicated.¹ A new PDA-approved bioengineered skin substitute has become available for the treatment of venous ulcers. This human skin equivalent is a living allogeneic cultured bilayer containing both epidermal and dermal components. The cellular components, human keratinocytes and dermal fibroblasts, are derived from neonatal foreskin, while the dermal matrix, type-I collagen, is bovine in origin.² It has been transplanted without adverse immune responses in animals and humans.^3-5 The human skin equivalent used in this case report is approved for the treatment of venous leg ulcers, and has been studied in human acute wounds as well.^4-5 We describe a patient with mixed arterial and venous disease and chronic ulceration of the lower extremity that responded to treatment with this human skin equivalent.