CHIH-CHUNG YANGYeong, E.K.E.K.YeongCHIH-CHUNG YANG2018-09-102018-09-102004http://www.scopus.com/inward/record.url?eid=2-s2.0-0346399722&partnerID=MN8TOARShttp://scholars.lib.ntu.edu.tw/handle/123456789/307830We report two siblings suffered from Werner's syndrome, which is a rare premature aging disorder caused by genetic mutations. They developed premature aging during adolescence with loss and graying of hair, short stature, baldness, atrophic skin, thin extremities, flat feet, 'bird' face and cataracts. Multiple chronic ulcers were noted over the feet in both patients. Heating was prolonged because of atrophic subcutaneous tissue, poor perfusion, impaired fibroblast activity and the loss of normal foot architecture. Treatment of the ulcers was challenging, as flap options were limited over the lower third of the leg and skin grafting was not easy as there was a lack of healthy granulations. However, we have successfully closed the ulcers with Integra artificial skin and ultra-thin split thickness skin grafting with the scalp as donor site. The main purpose of this paper is to alert physicians to this syndrome when treatments are being planned for patients with chronic leg ulcers. ? 2003 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved.Chronic leg ulcers; Werner's syndrome[SDGs]SDG3antibiotic agent; adolescence; adult; alopecia; article; case report; cataract; chronic disease; debridement; face malformation; female; fibroblast; flatfoot; gene mutation; genetic analysis; human; leg ulcer; premature aging; priority journal; short stature; skin atrophy; skin graft; split thickness skin graft; subcutaneous tissue; tissue perfusion; Werner syndrome; wound healing impairmentjournal article10.1016/j.bjps.2003.10.011