I have already talked about this topic in different blog entries (Punch grafting= a classic back in fashion, Interest of early punch grafting in Martorell hypertensive ischemic ulcer).
But I have selected it as a therapeutic pearl because we have just published an international consensus document (embedded at the end of the post and downloadable here) in which this advanced treatment for stagnant wounds is included, even if the wound bed does not present optimal conditions.
What I have already commented in previous occasions is perfectly reflected in this document: “In cases where the wound bed does not present with the optimal granulation tissue to receive skin grafts (for example, if stagnant slough is present), the ulcer may benefit from autologous punch grafting. Although some pinch or punch grafts may not adhere to the wound bed, they release growth factors, signal molecules and cells that enhance epithelial resurfacing and reduce pain”.
I take this opportunity to encourage you to read this multi-perspective and holistic paper on the diagnostic and therapeutic challenge of “super chronic” wounds that we often manage in our clinic – Remember that before treating a wound you must understand the patient and the factors that are preventing wound closure!jowc.2019.28.sup3a.s1
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