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在一项多中心评估中,无菌、室温、脱细胞真皮基质与传统护理伤口管理及活性对照物治疗全层糖尿病足溃疡的愈合率。

Healing Rates in a Multicenter Assessment of a Sterile, Room Temperature, Acellular Dermal Matrix Versus Conventional Care Wound Management and an Active Comparator in the Treatment of Full-Thickness Diabetic Foot Ulcers.

作者信息

Walters Jodi, Cazzell Shawn, Pham Hau, Vayser Dean, Reyzelman Alexander

机构信息

Southern Arizona VA Health Care System, Tucson.

Limb Preservation Platform, Valley Vascular Surgical Associates, Fresno, Calif.

出版信息

Eplasty. 2016 Feb 4;16:e10. eCollection 2016.

Abstract

OBJECTIVE

The purpose of this 16-week, multicenter, randomized, controlled trial was to assess the healed ulcer rate of a human acellular dermal matrix, DermACELL, compared with conventional care and a second acellular dermal matrix, Graftjacket, in the treatment of full-thickness diabetic foot ulcers.

METHODS

One hundred sixty-eight patients were randomized into DermACELL, conventional care, and Graftjacket treatment arms in a 2:2:1 ratio. Patients in the acellular dermal matrix groups received either 1 or 2 applications of the graft at the discretion of the investigator. Weekly follow-up visits were conducted until the ulcer healed or the endpoint was reached.

RESULTS

At 16 weeks, the DermACELL arm had a significantly higher proportion of completely healed ulcers than the conventional care arm (67.9% vs 48.1%; P = .0385) and a nonsignificantly higher proportion than the Graftjacket arm (67.9% vs 47.8%; P = .1149). The DermACELL arm also exhibited a greater average percent reduction in wound area than the conventional care arm (91.4% vs 80.3%; P = .0791) and the Graftjacket arm (91.4% vs 73.5%; P = .0762). The proportion of severe adverse events and the proportion of overall early withdrawals were similar among the 3 groups based on relative population size (P ≥ .05).

CONCLUSIONS

The results presented here indicate that DermACELL is an appropriate clinical option in the treatment of diabetic foot ulcers, with significant increases in healing rates and rate of percentage wound closure as compared with conventional care options.

摘要

目的

这项为期16周的多中心随机对照试验旨在评估人脱细胞真皮基质DermACELL在治疗全层糖尿病足溃疡方面的愈合溃疡率,并与传统治疗方法以及另一种脱细胞真皮基质Graftjacket进行比较。

方法

168名患者按2:2:1的比例随机分为DermACELL组、传统治疗组和Graftjacket治疗组。脱细胞真皮基质组的患者由研究者酌情决定接受1次或2次移植物应用。每周进行随访,直至溃疡愈合或达到终点。

结果

在16周时,DermACELL组完全愈合溃疡的比例显著高于传统治疗组(67.9%对48.1%;P = 0.0385),且略高于Graftjacket组,但差异无统计学意义(67.9%对47.8%;P = 0.1149)。DermACELL组伤口面积的平均减少百分比也高于传统治疗组(91.4%对80.3%;P = 0.0791)和Graftjacket组(91.4%对73.5%;P = 0.0762)。基于相对人群规模,三组中严重不良事件的比例和总体早期退出的比例相似(P≥0.05)。

结论

此处呈现的结果表明,DermACELL是治疗糖尿病足溃疡的一种合适的临床选择,与传统治疗方法相比,愈合率和伤口闭合百分比显著提高。

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