Lullove Eric J
West Boca Center for Wound Healing (Medical Director), Boca Raton, FL.
Wounds. 2017 Nov;29(11):346-351. Epub 2017 Jan 23.
Injuries to the skin are extensively costly to the health care system. When caused by metabolic and vascular compromise, these injuries are even more foreboding for patients. They can result in chronic inflammation, reduced mobility, and chronic pain.
Twenty patients were selected from the author's patient population at the West Boca Center for Wound Healing for a retrospective cohort study. Patients underwent a run-in period of 2 weeks, where standard of care was used to clear the wound of bioburden. A dehydrated, human amniotic membrane (dHAM; WoundEx Membrane, Skye Biologics, Inc, El Segundo, CA) was applied at weeks 1 (2 weeks post run-in), 3, and 5, if necessary. Wound measurements and photographs were performed weekly. Data were collected through a standard form in each patient's medical record to improve reliability and reproducibility. The data extraction was performed by the author and to reduce bias. Reduction of bias was performed by selecting patients whose wounds already were established and in temporal sequence.
In this review of 20 patients treated with the dHAM, the author was able to effectively close all wounds in approximately 9.9 weeks (69.3 days). A linear relationship was discovered between wound size in cm2 and days to closure. Diabetic foot ulcers closed on average in 11.8 weeks (82.6 days) and venous leg ulcers in 9.2 weeks (64.4 days). No adverse events were noted secondary to the dHAM application, which shows this is a safe and effective treatment option. As of the date of this publication, there is no recurrence of the ulcerations noted.
The use of this particular dHAM allograft effectively closed diabetic foot ulcerations in 82.6 days and median wound closure in 69.3 days. This poses as an advantageous clinical benefit in the scope of treatment of lower extremity wounds.
皮肤损伤对医疗保健系统造成的成本高昂。当由代谢和血管受损引起时,这些损伤对患者来说更具不祥之兆。它们可导致慢性炎症、活动能力下降和慢性疼痛。
从作者在西博卡伤口愈合中心的患者群体中选取20例患者进行回顾性队列研究。患者经历了为期2周的导入期,在此期间采用标准护理清除伤口的生物负荷。如有必要,在第1周(导入期后2周)、第3周和第5周应用脱水人羊膜(dHAM;WoundEx Membrane,Skye Biologics公司,加利福尼亚州埃尔塞贡多)。每周进行伤口测量和拍照。通过每位患者病历中的标准表格收集数据,以提高可靠性和可重复性。数据提取由作者进行,以减少偏差。通过选择伤口已经形成且按时间顺序排列的患者来减少偏差。
在对20例接受dHAM治疗的患者的本次回顾中,作者能够在约9.9周(69.3天)内有效闭合所有伤口。发现伤口面积(平方厘米)与闭合天数之间存在线性关系。糖尿病足溃疡平均在11.8周(82.6天)内闭合,下肢静脉溃疡在9.2周(64.4天)内闭合。未观察到因应用dHAM继发的不良事件,这表明这是一种安全有效的治疗选择。截至本出版物发布之日,未发现溃疡复发。
使用这种特定的dHAM同种异体移植物可在82.6天内有效闭合糖尿病足溃疡,中位伤口闭合时间为69.3天。这在下肢伤口治疗范围内具有有利的临床益处。