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使用脱水羊膜/绒毛膜构建物处理伤口的临床经验。

Clinical experience using a dehydrated amnion/chorion membrane construct for the management of wounds.

作者信息

Caporusso Joseph, Abdo Raymond, Karr Jeffrey, Smith Mark, Anaim Ali

机构信息

Futuro Clinical Trials LLC, McAllen, TX.

St Louis Foot and Ankle LLC, Mercy Hospital, St Louis, MO.

出版信息

Wounds. 2019 Apr;31(4 Suppl):S19-S27.

Abstract

INTRODUCTION

Over time, acute and chronic, nonhealing wounds impose heavy financial and quality-of-life burdens on patients. The introduction of new therapies for wounds is essential in benefiting the patient, and in this report, the clinical experience of various wound care providers treating wounds with dehydrated amnion/chorion membrane (dACM) is presented.

OBJECTIVE

This retrospective clinical experience evaluated the effects of dACM in the treatment of 50 acute and chronic wounds of various etiologies.

MATERIALS AND METHODS

Retrospective case data of patients who received dACM as part of the course of treatment for a variety of acute and chronic wounds were obtained from 15 wound care institutions. The case data, consisting of patient history, previous wound care treatments, wound types and sizes, dACM applications and adjunctive treatments, and wound outcomes following dACM applications, were analyzed.

RESULTS

The mean (standard deviation [SD]) baseline wound areas were recorded for all wounds (N = 50; 11.251 cm2, SD = 15.575), venous leg ulcers (VLUs; n = 14; 18.756 cm2, SD = 20.848), diabetic foot ulcers (DFUs; n = 24; 10.387 cm2, SD = 14.432), and other wounds (n = 12; 4.225 cm2, SD = 2.074), respectively. With a mean of 5.9 (SD = 2.94) dACM applications per wound, 28 of 50 wounds (56%) achieved complete wound closure by the last observation. Of the ones that did not completely close, 9 (18%) had > 90% wound closure, and 8 (16%) had wound closure percentages ranging from 60% to 90% by the last observation. Of the total number of wounds, 45 (90%) had wound closure percentages between 60% to 100%. The median time to complete wound closure (or healing) for all wounds was 102 days (14.57 weeks), and the percent healing rates of all wounds healed at 16 and 24 weeks was 56% and 73%, respectively. For DFUs treated with dACM, the median time to healing was 120 days (17.14 weeks) and the percent healing rates at 16 and 24 weeks were 43% and 59%, respectively. For VLUs treated with dACM, the median time to healing was 90 days (12.86 weeks), with percent healing rates of 56% and 85% at 16 and 24 weeks, respectively. For all other wounds treated with dACM (including pressure ulcers, nonhealing surgical, ischemic, mixed etiology, and nonhealing amputation), the median time to healing was 48 days (6.86 weeks), with percent healing rates of 57% and 100% at 16 and 24 weeks, respectively.

CONCLUSIONS

This retrospective case compilation of clinical experiences in patients with various acute and chronic wounds demonstrates that dACM may be beneficial in the treatment of wounds.

摘要

引言

随着时间的推移,急慢性难愈合伤口给患者带来了沉重的经济负担和生活质量负担。引入新的伤口治疗方法对患者有益,在本报告中,介绍了各种伤口护理提供者使用脱水羊膜/绒毛膜(dACM)治疗伤口的临床经验。

目的

这项回顾性临床经验评估了dACM对50例各种病因的急慢性伤口的治疗效果。

材料与方法

从15个伤口护理机构获取了将dACM作为各种急慢性伤口治疗过程一部分的患者的回顾性病例数据。分析了病例数据,包括患者病史、先前的伤口护理治疗、伤口类型和大小、dACM应用及辅助治疗,以及dACM应用后的伤口结局。

结果

记录了所有伤口(N = 50;平均[标准差(SD)]基线伤口面积为11.251 cm²,SD = 15.575)、下肢静脉溃疡(VLUs;n = 14;18.756 cm²,SD = 20.848)、糖尿病足溃疡(DFUs;n = 24;10.387 cm²,SD = 14.432)和其他伤口(n = 12;4.225 cm²,SD = 2.074)的平均(标准差)基线伤口面积。每个伤口平均应用5.9次(SD = 2.94)dACM,50个伤口中有28个(56%)在最后一次观察时实现了伤口完全闭合。在未完全闭合的伤口中,9个(18%)伤口闭合率> 90%,8个(16%)在最后一次观察时伤口闭合率在60%至90%之间。在所有伤口总数中,45个(90%)伤口闭合率在60%至100%之间。所有伤口完全闭合(或愈合)的中位时间为102天(14.57周),在16周和24周愈合的所有伤口的愈合率分别为56%和73%。对于用dACM治疗的DFUs,愈合的中位时间为120天(17.14周),在16周和24周的愈合率分别为43%和59%。对于用dACM治疗的VLUs,愈合的中位时间为90天(12.86周),在16周和24周的愈合率分别为56%和85%。对于用dACM治疗的所有其他伤口(包括压疮、难愈合手术伤口、缺血性伤口、混合病因伤口和难愈合截肢伤口),愈合的中位时间为48天(6.86周),在16周和24周的愈合率分别为57%和100%。

结论

这份对各种急慢性伤口患者临床经验的回顾性病例汇编表明,dACM可能对伤口治疗有益。

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