Efficiency of Epidermal Grafts in Chronic Wounds: A Retrospective Observational Study.

Background and Aims: Chronic wounds represent a major challenge in medical management, requiring effective therapeutic approaches to promote healing. In recent years, epidermal grafts have emerged as a promising therapeutic option to improve the healing process of chronic wounds. This device only allows ultrasuperficial grafts to be performed using a suction/suction mechanism with a dermo-epidermal cleavage zone, unlike other superficial grafting techniques such as pellet or mesh grafts. There is little data in the literature regarding clinical studies because it is difficult to conduct comparative studies to evaluate the efficacy of grafts. The indications can be broad and the etiologies of the wounds varied, as we would like to illustrate. This retrospective study aims to evaluate the benefit of epidermal grafts in the treatment of chronic wounds. Method: A retrospective study was carried out over a period of 4 years, from 2019 to 2023. We used a so-called "superficial" grafting technique using an ultra superficial epidermal grafts CelluTome™ Epidermal Harvesting System (KCI, an Acelity company, San Antonio, USA). The objectives of these epidermal grafts could be twofold: either for analgesic purposes or to cover the wound to accelerate the healing process. Patient demographics, wound characteristics, treatment modalities, number of grafts and healing outcomes were collected and analyzed. Results: A total of 28 patients with chronic wounds were included in the study; 23 "vascular" wounds were treated (82.2%), including 11 of venous origin (39.3%), 5 of arterial origin (17.8%) and 7 mixed ulcers (25%). No side effects have been reported. Patient follow-up averaged 22.70 (19.52) weeks. For the 15 patients whose objective was healing, 4 were healed after 1 month after the last Cellutome®. Discussion: This retrospective study demonstrates the potential value of epidermal grafting as a treatment for seams in hard-to-heal wounds. Epidermal grafts offer a number of advantages in the field of wound healing, particularly in difficult, recalcitrant and multifactorial wounds. The ease with which these grafts can be performed (broad aetiological indications, ambulatory nature, no need for a complex technical platform, no need for anesthesia) makes them accessible to a large number of patients. Despite these advantages, the results of epidermal grafts in terms of efficacy are difficult to assess. We did not find any comparative studies between the different superficial grafts. Conclusion: This procedure undoubtedly deserves to be better known and more widely used to optimize the experiments, particularly with regard to heating times.