Chronic lower limb ulcers represent a significant healthcare burden. The predominant aetiology of these ulcers is venous. Compression therapy is the gold standard for venous leg ulcers, while revascularisation is required for arterial ulcers. Skin grafts, including punch grafts, offer an alternative treatment, accelerating wound healing and reducing pain.

This cohort study consisted of 93 patients with chronic leg ulcers that were treated between January 2016 to August 2022 with a punch graft procedure, by transplanting skin punches from the thigh to the ulcer. The study outcomes were the evaluation of the wound surface reduction, the healing rate and the changes in pain levels. Follow-up assessments were performed at 1, 3, 6 and 12 months postoperatively.

Wound healing occurred in 84 (90.3%) patients after 12 months, with a mean wound surface area reduction from 9.1 cm² (SD 9.5) to 1.7 cm2 (SD 6.9). Venous and atypical ulcers were the most represented aetiology. No pain was documented in 17 (18.3%) patients pre-operatively and in 62 (66.7%) patients 6 months postoperatively. Complications occurred in 22 (23.7%) patients and were predominantly infections. 12 (12.9%) patients experienced a recurrence within one year of closure of the ulcer.

Punch grafting effectively treats chronic leg ulcers by significantly reducing wound size, alleviating pain, and achieving a high rate of complete healing.