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一种用于慢性下肢伤口管理的新型重组人胶原蛋白基可流动基质:一项临床试验的初步结果。

A Novel Recombinant Human Collagen-based Flowable Matrix for Chronic Lower Limb Wound Management: First Results of a Clinical Trial.

作者信息

Wiser Itay, Tamir Eran, Kaufman Hanna, Keren Elad, Avshalom Shalom, Klein Doron, Heller Lior, Shapira Eyal

机构信息

Department of Plastic Surgery, Assaf Harofeh Medical Center, Zerifin, Israel; Department of Epidemiology and Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Maccabi Health Care Services, Diabetic Institute, Maccabi Hashalom, Tel Aviv, Israel.

出版信息

Wounds. 2019 Apr;31(4):103-107. Epub 2019 Feb 14.

Abstract

BACKGROUND

Chronic ulcers pose a significant health concern and economic burden. Numerous products, including animal-derived collagen products, have been designed to provide the injured site with a biocompatible structural matrix that promotes tissue regeneration. Yet, animal-derived collagens can evoke immune responses, bear risk of disease transmission, and fail to closely mimic the function of native collagen.

OBJECTIVE

This study aims to assess the safety and performance of a novel flowable wound matrix, formulated from tobacco plant-purified fibrillated recombinant human type I collagen (rhCollagen), in patients with chronic lower limb ulcers.

MATERIALS AND METHODS

This single-arm, open-label, multicenter trial took place at 5 treatment centers. Wounds were photographed and preliminary surgical debridement was performed prior to rhCollagen application. Patients received a single application of rhCollagen to the wound bed, followed by weekly assessments of the wound.

RESULTS

Twenty patients (mean age, 63 years), presenting with a chronic ulcer of neuropathic (45%), posttraumatic (35%), postoperative (10%), and venous (10%) origin, underwent rhCollagen treatment. Initial wound area ranged between 0.2 cm3 to 9.2 cm3. At 4-weeks posttreatment, median wound area reduction was 94%. Fifteen ulcers exhibited ≥ 70% wound closure, 9 of which achieved complete closure. Only 1 participant suffered a local self-resolving wound infection. No significant device-related adverse events were reported throughout the study.

CONCLUSIONS

A single, easy-to-use rhCollagen flowable gel application for chronic lower limb ulcers may promote wound closure with minimal adverse events.

摘要

背景

慢性溃疡对健康构成重大威胁并带来经济负担。许多产品,包括动物源胶原蛋白产品,已被设计用于为受伤部位提供促进组织再生的生物相容性结构基质。然而,动物源胶原蛋白可引发免疫反应,存在疾病传播风险,且无法紧密模拟天然胶原蛋白的功能。

目的

本研究旨在评估一种由烟草植物纯化的原纤维重组人I型胶原蛋白(rhCollagen)制成的新型可流动伤口基质在慢性下肢溃疡患者中的安全性和性能。

材料与方法

这项单臂、开放标签、多中心试验在5个治疗中心进行。在应用rhCollagen之前,对伤口进行拍照并进行初步手术清创。患者在伤口床单次应用rhCollagen,随后每周对伤口进行评估。

结果

20例患者(平均年龄63岁)接受了rhCollagen治疗,其慢性溃疡的病因包括神经性(45%)、创伤后(35%)、术后(10%)和静脉性(10%)。初始伤口面积在0.2 cm³至9.2 cm³之间。治疗后4周,伤口面积中位数减少了94%。15处溃疡的伤口闭合率≥70%,其中9处实现了完全闭合。只有1名参与者发生了局部自行消退的伤口感染。在整个研究过程中未报告与器械相关的重大不良事件。

结论

单次、易于使用的rhCollagen可流动凝胶应用于慢性下肢溃疡可能以最小的不良事件促进伤口闭合。

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