Hart Charles E, Loewen-Rodriguez Andrea, Lessem Jan
Advanced BioHealing, Inc. , Brentwood, Tennessee.
Adv Wound Care (New Rochelle). 2012 Jun;1(3):138-141. doi: 10.1089/wound.2011.0282.
Lower limb ulceration is a common problem in clinical practice. A variety of metabolic and physical causes can lead to a diversity of chronic ulcer types, including diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs).
A wide variety of technologies have been developed to treat chronic wounds, with varying levels of success. Depending upon the type and severity of the wound being treated, treatments may include systemic or local antibiotic therapy, application of fillers such as collagen sponges, use of negative wound pressure, hyperbaric oxygen therapy, application of select growth factors, advanced wound dressings, and more recently, the use of cell-based tissue-engineered products.
Dermagraft is a sterile, cryopreserved, human fibroblast-derived dermal substitute generated by the culture of neonatal dermal fibroblasts onto a bioabsorbable polyglactin mesh scaffold. During the product-manufacturing process, the human fibroblasts proliferate to fill the interstices of this scaffold and secrete collagen, other extracellular matrix proteins, growth factors, and cytokines, creating a three-dimensional human tissue containing metabolically active living cells.
Dermagraft has been approved for marketing in the United States for the treatment of DFUs. In addition, the product is in active development for the treatment of VLUs and has been clinically used in a variety of other indications to stimulate wound healing.
When treating DFUs, Dermagraft should be used in conjunction with standard wound care regimens and in patients who have adequate blood supply to the involved foot.
下肢溃疡是临床实践中的常见问题。多种代谢和物理原因可导致多种慢性溃疡类型,包括糖尿病足溃疡(DFU)和下肢静脉溃疡(VLU)。
已开发出多种技术来治疗慢性伤口,成功率各不相同。根据所治疗伤口的类型和严重程度,治疗方法可能包括全身或局部抗生素治疗、应用填充剂(如胶原海绵)、使用负压伤口疗法、高压氧治疗、应用特定生长因子、使用先进的伤口敷料,以及最近使用基于细胞的组织工程产品。
Dermagraft是一种无菌、冷冻保存的人成纤维细胞衍生的真皮替代物,通过将新生儿真皮成纤维细胞培养在可生物吸收的聚乙醇酸网状支架上生成。在产品制造过程中,人成纤维细胞增殖以填充该支架的间隙并分泌胶原蛋白、其他细胞外基质蛋白、生长因子和细胞因子,形成一个包含代谢活跃活细胞的三维人体组织。
Dermagraft已在美国获批上市用于治疗糖尿病足溃疡。此外,该产品正在积极开发用于治疗下肢静脉溃疡,并已临床用于多种其他适应症以促进伤口愈合。
治疗糖尿病足溃疡时,Dermagraft应与标准伤口护理方案联合使用,并用于受累足部血液供应充足的患者。