In this study, the effectiveness of a tissue-engineered skin (Activskin; Aierfu, Xi'an, China) was evaluated for the treatment of various refractory ulcers. These ulcers were treated with Activskin after debridement and irrigation with saline. A second application of Activskin was essential if the first application failed to persist on the wounds. Clinical efficacy and safety were assessed at regular clinic visits during 6 months of follow-up. All 11 treated patients improved with Activskin. The ulcers healed by inward migration from the wound edge. The average healing time was 27.8 days. No recurrent ulceration or other adverse events were observed during follow-up. These results provide preliminary evidence that Activskin is safe and effective in the management of refractory ulcers.