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同种异体角质形成细胞治疗难治性慢性糖尿病足溃疡:一项前瞻性观察研究。

Allogeneic keratinocyte for intractable chronic diabetic foot ulcers: A prospective observational study.

机构信息

Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Int Wound J. 2019 Apr;16(2):486-491. doi: 10.1111/iwj.13061. Epub 2019 Jan 2.

Abstract

Chronic diabetic foot ulcers (DFUs) are a common problem in patients with diabetes and are often difficult to treat. The application of newly developed dressing material in patients with chronic DFUs has been reported to be effective. The purpose of this study was to evaluate the usefulness of allogeneic keratinocyte treatment for chronic DFUs. We performed weekly allogeneic keratinocyte treatment for up to 12 weeks in 71 patients with intractable DFUs. We investigated healing rate, wound-healing velocity, and time to 50% wound size reduction and analysed factors affecting ulcer healing. Fifty-six patients (78.8%) had complete wound healing. Forty-six patients (64.7%) showed complete healing within an average of 6.1 weeks, and 10 patients (14.1%) showed partial healing with an average 35.5% reduction vs initial size at the end of follow up. The 10 patients who showed partial healing continued to receive treatment after the 12-week study period. The mean time to complete wound healing was 7.8 weeks. Fifteen patients (21.1%) experienced treatment failure because of infection, local necrosis, no change in ulcer size, or osteomyelitis during the follow-up period. No adverse events were observed. Allogeneic keratinocyte treatment is effective for chronic, difficult-to-treat DFUs.

摘要

慢性糖尿病足溃疡(DFU)是糖尿病患者常见的问题,且往往难以治疗。据报道,在慢性 DFU 患者中应用新开发的敷料材料是有效的。本研究旨在评估同种异体角质形成细胞治疗慢性 DFU 的实用性。我们对 71 例难治性 DFU 患者每周进行同种异体角质形成细胞治疗,最长达 12 周。我们调查了愈合率、伤口愈合速度以及 50%伤口面积缩小所需的时间,并分析了影响溃疡愈合的因素。56 例(78.8%)患者的伤口完全愈合。46 例(64.7%)患者平均在 6.1 周内完全愈合,10 例(14.1%)患者显示部分愈合,平均缩小初始面积的 35.5%,在随访结束时。10 例显示部分愈合的患者在 12 周研究期后继续接受治疗。完全愈合的平均时间为 7.8 周。在随访期间,有 15 例(21.1%)患者因感染、局部坏死、溃疡大小无变化或骨髓炎而治疗失败。未观察到不良事件。同种异体角质形成细胞治疗对慢性、难治性 DFU 有效。

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