Angiology Department, MD Barbantini Clinic, Lucca, Italia.
Department of Clinical Physiology, Institute of Clinical Physiology, Italian National Research Council e CNR, Pisa, Italy.
Dermatol Surg. 2020 Feb;46(2):169-179. doi: 10.1097/DSS.0000000000001990.
Leg ulcers that do not heal despite appropriate treatment are defined as recalcitrant ulcers. Large surface area, depth, and long duration represent some of most important factors impeding ulcer healing. After sharp debridement, dermal substitutes including skin from cadaver donors may increase the healing rate of recalcitrant ulcers reducing the risk of scar formation and recurrence.
Assessing if, after sharp debridement, dermal substitutes including skin from cadaver donors may increase the healing rate of recalcitrant ulcers reducing the risk of scar formation and recurrence.
Among patients admitted to our hospital for all types of chronic leg ulcers, we retrospectively reviewed the records of patients affected by recalcitrant ulcers (surface greater than 100 cm, tissue loss involving epidermis, dermis, and subcutaneous tissue, duration longer than 1 year, and showing no healing tendency). After sharp debridement, the ulcers were covered by allografts with strict follow-up after discharge. Multiple allografts were performed when necessary, and a final autograft was applied in case of incomplete healing.
The records of 414 patients were analyzed. Forty-three patients were lost at follow-up, and the remaining 371 healed after 765 grafting procedures. In 163 patients, the ulcers healed by means of a final autograft. In all the remaining cases, allograft led to ulcer healing.
Allografts represent an effective treatment option in case of recalcitrant, large, deep and long-lasting leg ulcers.
经过适当治疗仍未愈合的腿部溃疡被定义为难治性溃疡。较大的表面积、深度和较长的持续时间是阻碍溃疡愈合的一些最重要的因素。在进行锐性清创后，包括尸体供体皮肤在内的真皮替代物可以提高难治性溃疡的愈合率，降低疤痕形成和复发的风险。
评估在进行锐性清创后，包括尸体供体皮肤在内的真皮替代物是否可以提高难治性溃疡的愈合率，降低疤痕形成和复发的风险。
在因各种慢性腿部溃疡而入院的患者中，我们回顾性地查阅了难治性溃疡（表面积大于 100cm²，组织损失涉及表皮、真皮和皮下组织，持续时间超过 1 年，且没有愈合趋势）患者的记录。在进行锐性清创后，使用同种异体移植物覆盖溃疡，并在出院后进行严格随访。必要时进行多次同种异体移植物移植，如果未完全愈合，则应用最终自体移植物。
分析了 414 名患者的记录。43 名患者在随访时丢失，其余 371 名患者在 765 次移植手术后愈合。在 163 名患者中，溃疡通过最终自体移植物愈合。在所有其余病例中，同种异体移植物导致溃疡愈合。
同种异体移植物是治疗难治性、大、深和长期腿部溃疡的有效治疗选择。
