Marangi Giovanni Francesco, Pallara Tiziano, Cagli Barbara, Schena Emiliano, Giurazza Francesco, Faiella Elio, Zobel Bruno Beomonte, Persichetti Paolo
Department of Plastic and Reconstructive Surgery, "Campus Bio-Medico di Roma" University, Via A. del Portillo 200, 00128 Rome, Italy.
Laboratory of Research in Biomedical Instrumentation and Measurements, "Campus Bio-Medico di Roma" University, Via A. del Portillo 200, 00128 Rome, Italy.
Plast Surg Int. 2014;2014:817283. doi: 10.1155/2014/817283. Epub 2014 Apr 10.
Assessing pressure ulcers (PUs) in early stages allows patients to receive safer treatment. Up to now, in addition to clinical evaluation, ultrasonography seems to be the most suitable technique to achieve this goal. Several treatments are applied to prevent ulcer progression but none of them is totally effective. Furthermore, the in-depth knowledge of fat regenerative properties has led to a wide use of it. With this study the authors aim at introducing a new approach to cure and prevent the worsening of early-stage PUs by using fat grafts. The authors selected 42 patients who showed clinical and ultrasonographic evidence of early-stage PUs. Values of skin thickness, fascial integrity, and subcutaneous vascularity were recorded both on the PU area and the healthy trochanteric one, used as control region. Fat grafting was performed on all patients. At three months, abnormal ultrasonographic findings, such as reduction of cutaneous and subcutaneous thickness, discontinuous fascia, and decrease in subcutaneous vascularity, all were modified with respect to almost all the corresponding parameters of the control region. Results highlight that the use of fat grafts proved to be an effective treatment for early-stage PUs, especially in the care of neurological and chronic bedridden patients.
早期评估压疮(PU)可使患者获得更安全的治疗。到目前为止,除了临床评估外,超声检查似乎是实现这一目标最合适的技术。有几种治疗方法用于预防溃疡进展,但没有一种是完全有效的。此外,对脂肪再生特性的深入了解导致了其广泛应用。通过本研究,作者旨在引入一种新方法,即使用脂肪移植来治愈和预防早期压疮的恶化。作者选择了42例有早期压疮临床和超声证据的患者。在压疮区域和作为对照区域的健康转子区域记录皮肤厚度、筋膜完整性和皮下血管情况的值。对所有患者进行脂肪移植。三个月时,与对照区域几乎所有相应参数相比,超声检查异常结果,如皮肤和皮下厚度减少、筋膜连续性中断和皮下血管减少,均得到改善。结果表明,脂肪移植被证明是治疗早期压疮的有效方法,尤其是在神经疾病和慢性卧床患者的护理中。