Griffin Leah, Carter Marissa J, D'Agostino Ralph, D'Agostino McGowan Lucy
KCI, San Antonio, TX.
Strategic Solutions, Inc, Cody, WY.
Wounds. 2019 Nov;31(11):E73-E76.
Chronic wounds are characterized by impaired tissue physiology that stalls healing. The prevalence of wound chronicity presents challenges in wound management and health care cost-containment.
This comparative effectiveness study evaluates the value proposition of 2 collagen-containing wound dressings - oxidized regenerated cellulose (ORC)/collagen/silver-ORC dressing and ovine collagen extracellular matrix (ECM) - in matched cohorts of patients undergoing treatment for diabetic foot ulcers (DFUs).
Data extracted from the US Wound Registry identified DFUs treated with either dressing and included wounds with complete data records (n = 3230). Thirty-seven variables were considered in propensity score matching to develop a case-matched cohort of 844 DFUs (n = 422 DFUs/group).
The ORC/collagen/silver-ORC dressing group yielded a significantly higher percentage of DFUs that healed or improved (82% vs. 74.6%; P = .0096). The ovine collagen ECM dressing group yielded a significantly higher percentage of DFUs that worsened (15.2% vs. 23.9%; P = .0013). The ORC/collagen/silver-ORC dressing group demonstrated a higher percentage of DFUs that attained 75% to 100% granulation at zero depth at 4, 8, 12, and 16 weeks. Median time to 75% to 100% granulation was 42 days for the ORC/collagen/silver-ORC dressing group versus 60 days for the ovine collagen ECM dressing group (P = .0109).
According to this comparative effectiveness study using real world data, ORC/collagen/silver-ORC dressing appears to afford improved healing and reduced time to granulation relative to ovine collagen ECM dressing.
慢性伤口的特征是组织生理功能受损,导致愈合停滞。伤口慢性化的发生率给伤口管理和医疗成本控制带来了挑战。
这项比较有效性研究评估了两种含胶原蛋白的伤口敷料——氧化再生纤维素(ORC)/胶原蛋白/银-ORC敷料和羊源胶原蛋白细胞外基质(ECM)——在接受糖尿病足溃疡(DFU)治疗的匹配患者队列中的价值主张。
从美国伤口登记处提取的数据确定了接受这两种敷料治疗的DFU,并纳入了具有完整数据记录的伤口(n = 3230)。在倾向得分匹配中考虑了37个变量,以建立一个由844个DFU组成的病例匹配队列(每组n = 422个DFU)。
ORC/胶原蛋白/银-ORC敷料组愈合或改善的DFU百分比显著更高(82%对74.6%;P = .0096)。羊源胶原蛋白ECM敷料组恶化的DFU百分比显著更高(15.2%对23.9%;P = .0013)。ORC/胶原蛋白/银-ORC敷料组在4、8、12和16周时零深度达到75%至100%肉芽组织形成的DFU百分比更高。ORC/胶原蛋白/银-ORC敷料组达到75%至100%肉芽组织形成的中位时间为42天,而羊源胶原蛋白ECM敷料组为60天(P = .0109)。
根据这项使用真实世界数据的比较有效性研究,与羊源胶原蛋白ECM敷料相比,ORC/胶原蛋白/银-ORC敷料似乎能促进愈合并缩短肉芽组织形成时间。