Payne W G, Ochs D E, Meltzer D D, Hill D P, Mannari R J, Robson L E, Robson M C
Department of Surgery, University of South Florida, Tampa, Florida, USA.
Am J Surg. 2001 Jan;181(1):81-6. doi: 10.1016/s0002-9610(00)00536-5.
Exogenous application of growth factors have been reported in an attempt to accelerate healing of chronic wounds. Most of the trials were of brief duration with short to no follow-up periods. Long-term outcome studies are sparse for pressure ulcer therapies with success rates around 30% for both operative and nonoperative treatments.
Follow-up evaluations were performed serially up to 12 months for patients completing a 35 day blinded, placebo-controlled cytokine clinical trial of pressure ulcers.
Fifty-four of 61 patients completed the follow-up period with 68.5% of the patients (37 of 54) being healed after 1 year. Of patients healing > or =85% during the active treatment phase, 84.6% were healed after 1 year compared with 61% of those that healed <85% during treatment (P <0.05).
Long-term outcome was better in this growth factor trial than with surgical or standard nonoperative treatment of pressure ulcers. Since only patients receiving exogenously applied cytokines achieved >85% closure during the treatment phase of the trial, the excellent long-term outcome appears attributable to the cytokine therapy.
已有报道尝试通过外源性应用生长因子来加速慢性伤口的愈合。大多数试验持续时间较短,随访期短甚至没有随访期。关于压疮治疗的长期结局研究较少,手术和非手术治疗的成功率均约为30%。
对完成一项为期35天的压疮细胞因子盲法、安慰剂对照临床试验的患者进行长达12个月的连续随访评估。
61例患者中有54例完成了随访期,1年后68.5%的患者(54例中的37例)愈合。在积极治疗阶段愈合≥85%的患者中,84.6%在1年后愈合,而治疗期间愈合<85%的患者中这一比例为61%(P<0.05)。
在该生长因子试验中,长期结局优于压疮的手术或标准非手术治疗。由于在试验治疗阶段只有接受外源性细胞因子治疗的患者实现了≥85%的伤口闭合,因此出色的长期结局似乎归因于细胞因子治疗。