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一项多中心、随机、对照临床试验,评估使用脱水人羊膜/绒毛膜同种异体移植物与多层压迫疗法联合治疗与单独使用多层压迫疗法治疗下肢静脉溃疡的效果。

A multicenter, randomized, controlled clinical trial evaluating the use of dehydrated human amnion/chorion membrane allografts and multilayer compression therapy vs. multilayer compression therapy alone in the treatment of venous leg ulcers.

作者信息

Serena Thomas E, Carter Marissa J, Le Lam T, Sabo Matthew J, DiMarco Daniel T

机构信息

Clinical Research, SerenaGroup Wound and Hyperbaric Centers, Cambridge, Massachusetts.

出版信息

Wound Repair Regen. 2014 Nov-Dec;22(6):688-93. doi: 10.1111/wrr.12227. Epub 2015 Jan 8.

Abstract

Venous leg ulcers produce significant clinical and economic burdens on society and often require advanced wound therapy. The purpose of this multicenter, randomized, controlled study is to evaluate the safety and efficacy of one or two applications of dehydrated human amnion/chorion membrane allograft and multilayer compression therapy vs. multilayer compression therapy alone in the treatment of venous leg ulcers. The primary study outcome was the proportion of patients achieving 40% wound closure at 4 weeks. Of the 84 participants enrolled, 53 were randomized to receive allograft and 31 were randomized to the control group of multilayer compression therapy alone. At 4 weeks, 62% in the allograft group and 32% in the control group showed a greater than 40% wound closure (p = 0.005), thus showing a significant difference between the allograft-treated groups and the multilayer compression therapy alone group at the 4-week surrogate endpoint. After 4 weeks, wounds treated with allograft had reduced in size a mean of 48.1% compared with 19.0% for controls. Venous leg ulcers treated with allograft had a significant improvement in healing at 4 weeks compared with multilayer compression therapy alone.

摘要

下肢静脉性溃疡给社会带来了巨大的临床和经济负担,且常常需要先进的伤口治疗方法。这项多中心、随机、对照研究的目的是评估在治疗下肢静脉性溃疡时,应用一至两次脱水人羊膜/绒毛膜同种异体移植联合多层压迫疗法与单纯多层压迫疗法相比的安全性和有效性。主要研究结果是在4周时伤口闭合40%的患者比例。在纳入的84名参与者中,53名被随机分配接受同种异体移植,31名被随机分配到单纯多层压迫疗法的对照组。4周时,同种异体移植组62%的患者和对照组32%的患者伤口闭合超过40%(p = 0.005),因此在4周的替代终点时,同种异体移植治疗组与单纯多层压迫疗法组之间存在显著差异。4周后,接受同种异体移植治疗的伤口大小平均减少了48.1%,而对照组为19.0%。与单纯多层压迫疗法相比,同种异体移植治疗的下肢静脉性溃疡在4周时愈合情况有显著改善。

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