Clinical application of fresh fibroblast allografts for the treatment of diabetic foot ulcers: A pilot study
Clinical application of fresh fibroblast allografts for the treatment of diabetic foot ulcers: A pilot study
复制标题
DOI：
10.1097/01.prs.0000142415.57470.df
复制
发表时间：
2004-12-01
影响因子：
3.6
通讯作者：
Kim, WK
中科院分区：
文献类型：
--
作者：
Han, SK;Choi, KJ;Kim, WK
糖尿病足溃疡往往构成一个难题，因为与成纤维细胞功能的缺陷，卫生保健专业人员。虽然最近有很多兴趣在使用局部生长因子治疗糖尿病足溃疡，效果一般不是很显着。冷冻保存的成纤维细胞植入物能够适应伤口环境并提供所需的生长因子和慢性伤口中可能缺乏的其他物质，代表了令人兴奋的发展和重大进步。这些产品可以很好地以正确的浓度和正确的顺序提供生长因子，这已被证明是重组生长因子的局部应用难以实现的。然而，冷冻保存会损害细胞活性。本研究的目的是评估新鲜同种异体人成纤维细胞移植治疗糖尿病足溃疡的效果。8例糖尿病足溃疡患者，持续时间为6至17周。伤口大小为2.0至6.0 cm（2），3名患者显示骨骼暴露。5例患者有糖尿病足溃疡病史。用含10%抗真菌血清的Dulbecco改良Eagle培养基/Ham’s F-12培养健康青少年皮肤成纤维细胞。清创后立即将培养的细胞应用于伤口上;纤维蛋白用作细胞载体。然后使用Tegadaline敷料，并保持湿润，直至愈合完成。评估伤口完全闭合的进展和时间以及患者满意度，随访时间范围为6至18个月。所有患者伤口均完全愈合。伤口完全上皮再生需要11 - 21天，未观察到临床或实验室异常。患者满意度也非常高。在这项研究中，使用新鲜的人成纤维细胞同种异体移植物被发现是一种安全有效的治疗糖尿病足溃疡。
Diabetic foot ulcers often pose a difficult problem for health care professionals because of the defects associated with fibroblast functioning. Although there has been much interest recently in the use of topical growth factors for the treatment of diabetic foot ulcers, the effects are generally not very dramatic. Cryopreserved fibroblast implants, which are able to adjust to a wound's environment and provide the desired growth factors and other substances that may be lacking in a chronic wound, represent an exciting development and a major advance. These products may well provide growth factors in the right concentration and in the right sequence, something that has proved difficult to achieve with the topical application of recombinant growth factors. However, cell activities are impaired by cryopreservation. The purpose of this study was to assess the effects of fresh human allogeneic fibroblast grafting for the treatment of diabetic foot ulcers. Eight patients with diabetic foot ulcers ranging from 6 to 17 weeks in duration were treated. The size of the wounds ranged from 2.0 to 6.0 cm(2), With three patients exhibiting exposed bones. A history of diabetic foot ulcers was present in five patients. Human dermal fibroblasts front healthy teenagers were cultured in Dulbecco's modified Eagle medium/Ham's F-12 supplemented with 10% antologous serum. The cultured cells were applied over the wounds immediately after debridement; fibrin was used as a cell carrier. A dressing was then applied with Tegaderm and kept moist until healing was complete. The progress and time for complete wound closure and patient satisfaction were assessed, with follow-up time ranging from 6 to 18 months. Complete wound healing occurred in all patients. Eleven to 21 days were needed for complete reepithelization of the wound, and no clinical or laboratory abnormalities were noted. Patient satisfaction was also very positive. In this study, the use of fresh human fibroblast allografts was found to be a safe and effective treatment for diabetic foot ulcers.