Khachemoune Amor, Bello Ysabel M, Phillips Tania J
Division of Dermatology, Georgetown University Medical Center, Washington, DC 20007, USA.
Dermatol Surg. 2002 Mar;28(3):274-80. doi: 10.1046/j.1524-4725.2002.02833.x.
Cryopreserved epidermal cultures (CEC) offer an "off the shelf" treatment for chronic wounds. These cultures are derived from neonatal foreskin and grow rapidly in vitro to form epidermal sheets. They do not require a biopsy from the patient, an advantage compared to autografts. They seem to act as a biological dressing, stimulating epithelialization from the wound edges and adnexae, probably through growth factor release.
To summarize our recent experience with the use of CEC in chronic venous leg ulcers and to determine the factors that influence healing in chronic venous ulcers treated with CEC.
A single arm, open label study including a total of 11 patients with documented venous ulcers was performed. The study involved the application of cryopreserved epidermal cultures every other week to nonhealing leg ulcers for a total of 12 weeks or until complete healing of the ulcer.
A total of 11 patients with one or more leg ulcers were treated. The average age was similar in healed and unhealed groups. Seven patients completely healed after an average of 4.14 CEC applications. Four patients did not heal after a total of 12 CEC applications.
Predictors for failure to heal after CEC application in our patients were long wound duration, wound size, presence of lipodermatosclerosis, and history of failed prior split-thickness skin grafts.
冷冻保存的表皮培养物（CEC）为慢性伤口提供了一种“现成可用”的治疗方法。这些培养物源自新生儿包皮，在体外生长迅速，可形成表皮片。它们不需要从患者身上进行活检，这是与自体移植相比的一个优势。它们似乎起到生物敷料的作用，可能通过释放生长因子刺激伤口边缘和附属器的上皮形成。
总结我们近期使用CEC治疗慢性下肢静脉溃疡的经验，并确定影响CEC治疗慢性静脉溃疡愈合的因素。
进行了一项单臂、开放标签研究，共纳入11例有记录的静脉溃疡患者。该研究包括每隔一周将冷冻保存的表皮培养物应用于未愈合的腿部溃疡，共12周或直至溃疡完全愈合。
共治疗了11例有一处或多处腿部溃疡的患者。愈合组和未愈合组的平均年龄相似。7例患者在平均应用4.14次CEC后完全愈合。4例患者在总共应用12次CEC后未愈合。
在我们的患者中，CEC应用后愈合失败的预测因素为伤口持续时间长、伤口大小、存在脂肪皮肤硬化症以及既往中厚皮片移植失败史。
