Martin Billy R, Sangalang Melinda, Wu Stephanie, Armstrong David G
Department of Surgery, Southern Arizona Veterans Affairs Medical Center, Tucson, AZ, USA.
Int Wound J. 2005 Jun;2(2):161-5. doi: 10.1111/j.1742-4801.2005.00099.x.
The purpose of this study was to evaluate outcomes of persons with UT grade 2A neuropathic diabetic foot wounds treated with an acellular matrix. Data were abstracted for 17 consecutive patients with diabetes--76.5% males, aged 61.5 +/- 8.5 years with a mean glycated haemoglobin of 9.2 +/- 2.2% presenting for care at a large, multidisciplinary wound care centre. All patients received surgical debridement for their diabetic foot wounds and were placed on therapy consisting of a single application of an acellular matrix graft (GraftJacket; Wright Medical Technologies, Arlington, TN, USA) with dressing changes taking place weekly. Outcomes evaluated included time to complete wound closure and proportion of patients achieving wound closure in 20 weeks. Acellular matrix therapy was used as initial therapy and was sutured or stapled in place under a silicone-based non adherent dressing. Therapy was then followed by a moisture-retentive dressing until complete epithelialisation. In total, 82.4% of wounds measuring a mean 4.6 +/- 3.2 cm(2) healed in the 20-week evaluation period. For those that healed in this period, healing took place in a mean 8.9 +/- 2.7 weeks. We conclude that a regimen consisting of moist wound healing using an acellular matrix dressing may be a useful adjunct to appropriate diabetic foot ulcer care for deep, non-infected, non-ischaemic wounds. We await the completion of further trials in this area to confirm or refute this initial assessment.
本研究的目的是评估采用脱细胞基质治疗2A级糖尿病神经病变足溃疡患者的疗效。我们提取了一家大型多学科伤口护理中心连续17例糖尿病患者的数据，这些患者中男性占76.5%，年龄为61.5±8.5岁，平均糖化血红蛋白为9.2±2.2%。所有患者均接受了糖尿病足溃疡的手术清创，并接受了单一应用脱细胞基质移植物（GraftJacket；美国田纳西州阿灵顿市Wright Medical Technologies公司）的治疗，每周更换敷料。评估的结果包括伤口完全闭合的时间以及20周内实现伤口闭合的患者比例。脱细胞基质疗法作为初始疗法，在硅基非粘性敷料下缝合或钉合到位。然后采用保湿敷料直至完全上皮化。在20周的评估期内，平均面积为4.6±3.2 cm²的伤口中，82.4%愈合。对于在此期间愈合的伤口，平均愈合时间为8.9±2.7周。我们得出结论，对于深度、非感染、非缺血性伤口，采用脱细胞基质敷料进行湿性伤口愈合的方案可能是适当糖尿病足溃疡护理的有用辅助手段。我们等待该领域进一步试验的完成，以证实或反驳这一初步评估。
