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一项对188例连续患者进行的回顾性临床研究,以检验生物活性冷冻保存的人同种异体皮肤移植物(TheraSkin®)治疗糖尿病足溃疡和下肢静脉溃疡的有效性。

A retrospective clinical study of 188 consecutive patients to examine the effectiveness of a biologically active cryopreserved human skin allograft (TheraSkin®) on the treatment of diabetic foot ulcers and venous leg ulcers.

作者信息

Landsman Adam Scott, Cook Jeremy, Cook Emily, Landsman Arnold Robert, Garrett Philip, Yoon Joonhyun, Kirkwood Alfred, Desman Eric

机构信息

Harvard Medical School, Boston, Cambridge Health Alliance, Cambridge, Massachusetts, USA.

出版信息

Foot Ankle Spec. 2011 Feb;4(1):29-41. doi: 10.1177/1938640010387417. Epub 2010 Dec 6.

Abstract

A biologically active human skin allograft, currently distributed under the brand name TheraSkin(®), was examined for safety and efficacy in the treatment of venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs). The objective was to determine if TheraSkin could serve as a safe and effective alternative to bioengineered skin substitutes such as Apligraf(®) and Dermagraft(®). The authors conducted a retrospective study of 214 consecutive patients seen at the Inova Wound Center (Mt Vernon, Virginia), with either a DFU or a VLU. After excluding patients who did not meet the study criteria, the final eligible cohort consisted of 188 subjects, with 134 VLUs and 54 DFUs. Multivariate logistic regression was used to evaluate the relationship between baseline wound size and the proportion of healed wounds after 12 and 20 weeks from initial allograft application. The authors found that by the 12th week, DFUs closed 60.38% of the time and VLUs closed 60.77% of the time. After 20 weeks, the number of closed DFUs increased to 74.1% and the number of VLUs increased to 74.6%. The mean wound size in the DFU group was 6.2 cm(2) (±11.8) and 11.8 cm(2) (±22.5) in the VLU group. The mean number of TheraSkin allografts required ranged from 1 to 8, with an average of 2.03 (±1.47) at the 12-week point and an average of 3.23 (±2.77) at the 20-week point. Multivariate logistic regression was used to calculate the odds of wound healing by week 12 and week 20 in each group. The authors also analyzed adverse events and found TheraSkin to be noncontributory to any adverse events, verifying the safety of TheraSkin in this study population. In this study, TheraSkin has been shown to be highly effective for the treatment of both VLUs and DFUs with an acceptable safety profile.

摘要

一种目前以TheraSkin(®)品牌销售的具有生物活性的人皮肤同种异体移植物,被用于治疗下肢静脉溃疡(VLU)和糖尿病足溃疡(DFU)的安全性和有效性研究。目的是确定TheraSkin是否可以作为生物工程皮肤替代品如Apligraf(®)和Dermagraft(®)的安全有效替代品。作者对弗吉尼亚州弗农山Inova伤口中心连续就诊的214例患有DFU或VLU的患者进行了回顾性研究。在排除不符合研究标准的患者后,最终符合条件的队列包括188名受试者,其中134例VLU和54例DFU。使用多变量逻辑回归来评估基线伤口大小与初次同种异体移植应用后12周和20周愈合伤口比例之间的关系。作者发现,到第12周时,DFU愈合的时间占60.38%,VLU愈合的时间占60.77%。20周后,愈合的DFU数量增加到74.1%,VLU数量增加到74.6%。DFU组的平均伤口面积为6.2平方厘米(±11.8),VLU组为11.8平方厘米(±22.5)。所需TheraSkin同种异体移植物的平均数量为1至8个,在12周时平均为2.03(±1.47),在20周时平均为3.23(±2.77)。使用多变量逻辑回归计算每组在第12周和第20周伤口愈合的几率。作者还分析了不良事件,发现TheraSkin与任何不良事件无关,证实了TheraSkin在该研究人群中的安全性。在这项研究中,TheraSkin已被证明对治疗VLU和DFU都非常有效,且安全性良好。

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