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冷冻保存的羊膜/脐带组织在足踝手术中的安全性分析:124例连续病例系列研究

Safety analysis of cryopreserved amniotic membrane/umbilical cord tissue in foot and ankle surgery: a consecutive case series of 124 patients.

作者信息

DeMill Shyler L, Granata Jaymes D, McAlister Jeffrey E, Berlet Gregory C, Hyer Christopher F

机构信息

Orthopedics Northwest Yakima, Washington.

Orthopedic Foot and Ankle Center Westerville, Ohio.

出版信息

Surg Technol Int. 2014 Nov;25:257-61.

Abstract

Cryopreserved amnion tissues derived from amniotic membrane/umbilical cord (AM/UC) have been used extensively in ophthalmology for minimizing postoperative inflammation, pain, and adhesion formation following various surgical procedures. There is limited data in the current literature regarding the use of amnion tissue product in foot and ankle surgery. The purpose of this retrospective study is to report the short-term safety profile after in vivo application of cryopreserved AM/UC tissue use in foot and ankle surgery. A retrospective consecutive case series was performed for cases where amnion tissue was used with a minimum follow-up of 120 days between 2011 and 2012. The clinical outcomes of interest were postoperative infections, delayed or nonhealing wounds, adverse surgical site reactions, and repeat surgery for formal irrigation and debridement. One hundred twenty-four patients qualified for inclusion. Cryopreserved AM/UC tissue was introduced into the surgical wound and placed adjacent to the compromised and repaired tendons, most frequently in peroneal and Achilles tendon repairs. In this level IV consecutive case series cohort, there was an overall wound complication rate of 5.64%, with a re-operation rate of 1.6% (2/124). In each of these cases, patients had an irrigation and debridement with ultimate successful wound healing. The results of this study demonstrate that the use of amnion tissue in the foot and ankle setting is safe with a decreasing trend in overall complication rates compared with historically published norms.

摘要

源自羊膜/脐带(AM/UC)的冷冻保存羊膜组织已在眼科广泛应用,以减少各种手术术后的炎症、疼痛和粘连形成。目前关于羊膜组织产品在足踝外科手术中应用的数据有限。本回顾性研究的目的是报告冷冻保存的AM/UC组织在足踝外科手术中体内应用后的短期安全性概况。对2011年至2012年间使用羊膜组织且随访至少120天的病例进行了回顾性连续病例系列研究。关注的临床结局包括术后感染、伤口延迟愈合或不愈合、手术部位不良反应以及因正式冲洗和清创而进行的再次手术。124例患者符合纳入标准。将冷冻保存的AM/UC组织引入手术伤口,并放置在受损和修复的肌腱附近,最常用于腓骨肌腱和跟腱修复。在这个IV级连续病例系列队列中,总体伤口并发症发生率为5.64%,再次手术率为1.6%(2/124)。在每例此类病例中,患者均接受了冲洗和清创,伤口最终成功愈合。本研究结果表明,在足踝手术中使用羊膜组织是安全的,与既往公布的标准相比,总体并发症发生率呈下降趋势。

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