Department of Dermatology and Skin Surgery, Roger Williams Medical Center, Providence, Rhode Island 02908, USA.
Wound Repair Regen. 2010 Jan-Feb;18(1):21-5. doi: 10.1111/j.1524-475X.2009.00559.x.
Wound biopsies are an essential diagnostic component in the management of chronic wounds. First, the possibility of malignancy or infection in the wound often requires sampling of the wound edge and its bed. Secondly, several practice guidelines recommend biopsying wounds that have not responded to treatment after 2-6 weeks. However, there has always been a concern that the biopsy may worsen the wound and delay overall healing. In this report, we investigated the safety and effects of wound biopsies on overall chronic wound healing rates (advance of the wound edge per week toward the center) before and after the biopsy was performed. In a cohort of 14 consecutive patients with chronic wounds of the lower extremity, we found that postbiopsy chronic wound healing rates (0.99+/-1.18 mm/week; mean+/-SD) were not decreased and were actually higher than prebiopsy chronic wound healing rates (0.49+/-0.85 mm/week; mean+/-SD, p<0.05). In addition, we documented that healing of the biopsy sites up to the original wound edge occurred within 6 weeks in 11 of the 14 subjects. Therefore, we conclude that chronic wounds do not worsen after being biopsied and that wound biopsies are a safe procedure that does not delay overall healing of the chronic wound.
伤口活检是慢性伤口管理中不可或缺的诊断组成部分。首先,伤口边缘及其床内存在恶性肿瘤或感染的可能性通常需要取样。其次,一些实践指南建议对治疗后 2-6 周仍未反应的伤口进行活检。然而,人们一直担心活检可能会使伤口恶化并延迟整体愈合。在本报告中,我们研究了活检对伤口边缘每周向中心前进的慢性伤口整体愈合率(进展)的安全性和影响,即在进行活检之前和之后。在连续 14 例下肢慢性伤口的患者队列中,我们发现活检后慢性伤口愈合率(0.99+/-1.18mm/周;均值+/-标准差)并未降低,实际上高于活检前慢性伤口愈合率(0.49+/-0.85mm/周;均值+/-标准差,p<0.05)。此外,我们记录到 14 名受试者中有 11 名在 6 周内将活检部位愈合至原始伤口边缘。因此,我们得出结论,活检后慢性伤口不会恶化,伤口活检是一种安全的操作,不会延迟慢性伤口的整体愈合。