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使用生物材料的麻风病相关慢性伤口管理

Leprosy-associated Chronic Wound Management Using Biomaterials.

作者信息

Sivasubramanian Srinivasan, Mohana Sambasivam, Maheswari Paulraj, Victoria Victor, Thangam Ramar, Mahalingam Jayashri, Chandrasekar-Janebjer Gayathri, Savariar Vincent, Madhan Balaraman, Gunasekaran Palani, Kitambi Satish S

机构信息

Department of Virology, King Institute of Preventive Medicine and Research, Chennai, Tamil Nadu, India.

Center for Environmental Research and Development, LIFE, Loyola College, Chennai, Tamil Nadu, India.

出版信息

J Glob Infect Dis. 2018 Apr-Jun;10(2):99-107. doi: 10.4103/jgid.jgid_79_17.

Abstract

BACKGROUND

Deformities and neuropathic chronic ulcers are the common features associated with leprosy-cured individuals that impact their quality of life and impair rehabilitation efforts. The challenging aspects for treatment of chronic wounds are the factors that inhibit healing. We reasoned that limited success of various therapeutic interventions could be due to the fact that leprosy-cured individual's physiology gets acclimatized to having a chronic wound that any therapeutic intervention is counterbalanced to maintain at the wound site. Therefore, an alternative strategy would be to use biomaterials that gradually alter the wound site allowing the individual's physiology to participate in the healing process.

AIMS

Developing the human amnion (Amn)-derived biomaterial scaffolds and evaluating its use to heal chronic wounds in leprosy-cured but deformed persons (LCDPs).

MATERIALS AND METHODS

Using an enzymatic protocol, we have developed a rapid method to generate biomaterial scaffolds from discarded human Amn. A clinical trial on 26 LCDPs was performed with the biomaterial, and its wound-healing potential was then compared with LCDPs undergoing standard treatment procedure.

RESULTS

Biomaterial-based treatment of chronic wounds on LCDP displayed a higher efficiency in healing when compared to standard treatment.

CONCLUSIONS

This study exemplifies that biomaterial-based treatment of leprosy-wounds offers an excellent affordable alternative for wound management. This study underlines the importance of involving both local wound environment and systemic effects for healing. In addition, we highlight wound healing as a necessity for successful rehabilitation and reintegration of leprosy-cured person into the society.

摘要

背景

畸形和神经性慢性溃疡是麻风治愈者的常见特征,会影响他们的生活质量并阻碍康复进程。慢性伤口治疗面临的挑战在于抑制愈合的因素。我们推断,各种治疗干预效果有限可能是因为麻风治愈者的生理状态已适应慢性伤口的存在,任何治疗干预都会被抵消,从而维持伤口现状。因此,一种替代策略是使用生物材料逐渐改变伤口部位,使个体生理机能参与到愈合过程中。

目的

开发源自人羊膜(Amn)的生物材料支架,并评估其用于治愈麻风治愈但身体畸形者(LCDPs)慢性伤口的效果。

材料与方法

我们采用酶法开发了一种从废弃人羊膜快速制备生物材料支架的方法。对26名LCDPs患者进行了该生物材料的临床试验,并将其伤口愈合潜力与接受标准治疗程序的LCDPs患者进行比较。

结果

与标准治疗相比,基于生物材料的LCDP慢性伤口治疗在愈合方面显示出更高的效率。

结论

本研究表明,基于生物材料的麻风伤口治疗为伤口管理提供了一种经济实惠的优质替代方案。本研究强调了局部伤口环境和全身效应在愈合中的重要性。此外,我们强调伤口愈合对于麻风治愈者成功康复并重新融入社会的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/237a/5987379/40c64d572054/JGID-10-99-g001.jpg

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