Effectiveness of Punch Grafting in Promoting Healing and Reducing Pain in Hard-to-Heal Leg Ulcers
Summary: This single-centre retrospective cohort study (January 2016–December 2024) assessed partial-thickness punch grafting in 93 patients with chronic, hard-to-heal leg ulcers of various etiologies (venous, mixed, arterial, etc.) that remained recalcitrant despite best standard care and treatment of underlying factors. Grafts were harvested from the thigh using 4–6 mm punches, applied to the wound bed, and followed at 1, 3, 6, and 12 months. Primary outcome: complete wound healing. Secondary: pain reduction (via VAS or similar), wound surface area change, donor-site complications, cosmetic outcome, and recurrence. Among 88 analysable patients, 78 (88.6%) achieved full target-ulcer closure by 12 months. Pain improved markedly, with pain-free patients rising from 17.6% at baseline to 76.3% by 6 months. Donor-site issues were rare (6.5%), cosmetic results excellent, and recurrence low (9% within 12 months post-healing). Demonstrates punch grafting as a minimally invasive, effective, durable option for refractory leg ulcers with rapid pain relief and minimal morbidity—providing strong long-term real-world evidence across ulcer types.
Key Highlights:
- Healing rate: 88.6% complete closure of target ulcer at 12 months (78/88 patients).
- Pain relief: Pain-free proportion increased from 17.6% baseline to 76.3% at 6 months; rapid and sustained improvement.
- Safety: Donor-site complications in only 6.5%; excellent cosmetic outcomes at both graft and donor sites.
- Recurrence: Just 9% of healed ulcers recurred within 12 months of closure.
- Relevance: Effective for diverse hard-to-heal leg ulcers (including venous/mixed); minimally invasive alternative to more complex grafts or surgery; supports broader adoption in chronic wound clinics.
Read full article (subscription may be required)
Keywords: punch grafting, hard-to-heal leg ulcers, chronic leg ulcers, wound healing, pain reduction, partial-thickness graft