# Effectiveness of Punch Grafting in Promoting Healing and Reducing Pain in Hard‐to‐Heal Leg Ulcers

## TL;DR

Punch grafting is shown to be highly effective in healing chronic leg ulcers and significantly reducing pain with minimal complications.

## Contribution

This study provides new long-term data on the effectiveness of punch grafting for diverse ulcer types.

## Key findings

- 88.6% of patients achieved complete wound healing at 12 months.
- Pain-free patients increased from 17.6% at baseline to 76.3% at 6 months.
- Donor site complications were minimal (6.5%) and recurrence was low (9%).

## Abstract

Approximately 20% of chronic leg ulcers remain recalcitrant despite treatment of underlying factors and best standard of wound care. This study aimed to evaluate the effectiveness of partial‐thickness punch grafting in promoting healing and reducing pain in patients with chronic, hard‐to‐heal leg ulcers of various causes. In this single‐centre, retrospective cohort study, 93 patients were treated between January 2016 and December 2024, with follow‐up at 1, 3, 6 and 12 months. The primary outcome was complete wound healing, while secondary outcomes included pain reduction and wound surface changes. At 12 months, 78/88 analysed patients (88.6%) achieved complete healing of the target ulcer. Pain levels improved substantially, with the proportion of pain‐free patients increasing from 17.6% at baseline to 76.3% at 6 months. Donor site complications were minimal (6.5%) and cosmetic outcomes were excellent. Recurrence after 12‐month follow‐up occurred in only 9% of healed ulcers within 12 months. These results confirm that partial‐thickness punch grafting is a highly effective and minimally invasive technique for treating hard‐to‐heal leg ulcers, delivering durable healing, rapid pain relief and low morbidity. This study provides new long‐term data supporting the broad clinical utility of punch grafting across diverse ulcer types.