Human acellular dermal wound matrix for complex diabetic wounds
Human acellular dermal wound matrix for complex diabetic wounds
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DOI：
10.12968/jowc.2016.25.sup4.s17
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发表时间：
2016-04-01
影响因子：
1.9
通讯作者：
Rupert, P.
中科院分区：
文献类型：
--
作者：
Rupert, P.
目的：糖尿病溃疡是导致下肢截肢的最常见足部损伤，也是工业化国家非创伤性下肢截肢的最常见原因。大约 85% 的糖尿病相关下肢截肢发生在足部溃疡之前。尽管采取了预防措施，但仍出现足部溃疡时，应尽早开始适当的治疗，以帮助减轻糖尿病相关截肢的负担。最近的进展现在为这些患者提供了一种再生过程，通过用类似的组织替代受损或缺失的组织，而不是形成疤痕，用人类体皮修复伤口。本次产品评价的目的是测试再生产品对复杂糖尿病伤口的功效。方法：在伤口干预之前，治疗II型糖尿病和骨髓炎的潜在合并症。在手术室中，伤口接受了无菌手术擦洗，并用缝合在开放伤口上的再生组织基质或放置在足底隧道式伤口中的再生可流动软组织支架进行治疗。应用负压伤口治疗 (NPWT) 10-14 天，以创造一个促进伤口愈合的环境，固定移植物，并促进基质粘附到创面床。结果：在 17 周随访期结束时，所有伤口（两名患者中有 3 名）完全上皮化，没有任何并发症。结论：各种糖尿病患者均未出现并发症，伤口上皮化成功。 伤口，再生组织基质产品在伤口愈合方面迈出了下一步。 l 利益声明：PR 是 Acelity 公司 KCI 的顾问。
Objective: Diabetic ulcers are the most common foot injuries leading to lower-extremity amputation and the most common cause of non-traumatic lower extremity amputations in the industrialised world. Approximately 85% of all diabetes-related lower-extremity amputations are preceded by foot ulcers. When foot ulcers develop despite preventive measures, early and appropriate treatment should be initiated to help reduce the burden of diabetes-related amputations. Recent advances now offer these patients a regenerative process of restoring the wound with human integument by replacing damaged or missing tissue with similar tissue rather than scar formation. The aim of this product evaluation was to test the efficacy of regenerative products on complex diabetic wounds.Method: Before wound intervention, the underlying comorbidities of type II diabetes mellitus and osteomyelitis were treated. In the operating room, the wounds received a sterile surgical scrub and were treated with either regenerative tissue matrix sutured over the open wounds or regenerative flowable soft tissue scaffold placed in a plantar tunnelled wound. Negative pressure wound therapy (NPWT) was applied for 10-14 days to create an environment that promotes wound healing, to secure the grafts, and to facilitate adhesion of the matrix to the wound bed.Results: All wounds, three in two patients, completely epithelialised without any complications at the end of the 17-week follow-up period.Conclusion: With the absence of complications and successful wound epithelialisation in a variety of diabetic wounds, regenerative tissue matrix products have taken the next step forward in wound healing. l Declaration of interest: PR is a consultant for KCI, an Acelity company.