生物工程替代组织在糖尿病伤口愈合中的应用

Bioengineered alternative tissues in diabetic wound healing.

作者信息

Garwood Caitlin S, Steinberg John S, Kim Paul J

机构信息

Department of Plastic Surgery, Center for Wound Healing and Hyperbaric Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Road, Northwest, Washington, DC 20007, USA.

Georgetown University School of Medicine, Washington, DC, USA; Department of Plastic Surgery, Georgetown University School of Medicine, Center for Wound Healing and Hyperbaric Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Road, Northwest, Washington, DC 20007, USA.

出版信息

Clin Podiatr Med Surg. 2015 Jan;32(1):121-33. doi: 10.1016/j.cpm.2014.09.004.

DOI:10.1016/j.cpm.2014.09.004

PMID:25440423

Abstract

New advances in medicine and technology continually change how clinicians treat patients with the aim of improving outcomes. As technology continues to improve, the ability to treat patients will improve as well. Great progress has been made in diabetic wound healing with BATs and there will continue to be improvement with new products in the future. However, the current literature is replete with small case series and small cohort studies. With the exception of the pivotal trials conducted more than a decade ago, there is a lack of robust evidence for the use of BATs. More advanced BATs, including the use of MSCs, show promise but have yet to be studied in a rigid manner. It is important to apply fundamental principles of DFU care, including maximizing perfusion, off-loading, and debridement, before using of these more advanced therapies.

摘要

医学和技术的新进展不断改变临床医生治疗患者的方式，旨在改善治疗效果。随着技术不断进步，治疗患者的能力也会提高。生物活性敷料（BATs）在糖尿病伤口愈合方面已取得了巨大进展，未来新产品也将持续带来改善。然而，当前文献充斥着小病例系列和小队列研究。除了十多年前进行的关键试验外，缺乏使用BATs的有力证据。更先进的BATs，包括使用间充质干细胞（MSCs），显示出前景，但尚未以严格的方式进行研究。在使用这些更先进的疗法之前，应用糖尿病足溃疡（DFU）护理的基本原则，包括最大化灌注、减轻压力和清创，是很重要的。