Biomarkers of Skin Graft Healing in Venous Leg Ulcers


  • Klaus Kirketerp-Møller Copenhagen Wound Healing Center and Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
  • Petra Doerfler Akribes Biomedical Gmbh, Vienna, Austria
  • Nicole Schoefmann Akribes Biomedical Gmbh, Vienna, Austria
  • Barbara Wolff-Winiski Akribes Biomedical Gmbh, Vienna, Austria
  • Omid Niazi Copenhagen Wound Healing Center and Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
  • Vibeke Pless Copenhagen Wound Healing Center and Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
  • Tonny Karlsmark Copenhagen Wound Healing Center and Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
  • Magnus S. Ågren



venous leg ulcer, proteinase, cytokine, biomarker, wound healing, keratinocyte


There is a need for biomarkers that predict the success of transplantation of venous leg ulcers (with autologous split-thickness skin grafts). The primary objective of this exploratory study was to investigate the association between split-thickness skin graft healing in venous leg ulcers and candidate wound fluid biomarkers representing inflammatory cell and endogenous proteinase activities, and bioactivity. A secondary objective was to compare biomarker levels of the 17 venous leg ulcers with sterile split-thickness skin graft donor-site wounds in another 10 patients with venous leg ulcers. Wound fluids were collected for 24 h using a validated method. The concentration of preoperative matrix metalloproteinase-9 in wound fluid was higher in venous leg ulcers showing good healing (n = 10) than in venous leg ulcers showing poor healing (n = 7) 12 weeks after transplantation with meshed split-thickness skin grafts. The diagnostic value of matrix metalloproteinase-9 was good according to receiver-operating characteristic curve analysis. Matrix metalloproteinase activity in wound fluids from split-thickness skin graft donor-site wounds increased as a function of time and healing, but was still lower than matrix metalloproteinase activity in venous leg ulcer wound fluids, which showed increased levels of most biomarkers except for matrix metalloproteinase-9 and matrix metalloproteinase-2. In conclusion, wound fluid matrix metalloproteinase-9 concentration is a potential predictive biomarker of split-thickness skin graft healing in venous leg ulcers.

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Additional Files


2022-07-07 — Updated on 2022-09-05


How to Cite

Kirketerp-Møller, K., Doerfler, P., Schoefmann, N. ., Wolff-Winiski, B., Niazi, O., Pless, V., Karlsmark, T., & Ågren, M. S. (2022). Biomarkers of Skin Graft Healing in Venous Leg Ulcers. Acta Dermato-Venereologica, 102, adv00749. (Original work published July 7, 2022)

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