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一项关于低强度激光治疗联合自体成纤维细胞移植治疗糖尿病患者Ⅲ度烧伤创面愈合的开放标签研究。

An Open-Label Study of Low-Level Laser Therapy Followed by Autologous Fibroblast Transplantation for Healing Grade 3 Burn Wounds in Diabetic Patients.

作者信息

Nilforoushzadeh Mohammad Ali, Kazemikhoo Nooshafarin, Mokmeli Soheila, Zare Sona, Dahmardehei Mostafa, Vaghar Doost Reza, Momeni Mahnoush, Ansari Fereshteh

机构信息

Skin and Stem Cell Research Center,Tehran University of Medical Sciences, Tehran, Iran.

Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Lasers Med Sci. 2019 Fall;10(Suppl 1):S7-S12. doi: 10.15171/jlms.2019.S2. Epub 2019 Dec 1.

Abstract

Low-level laser therapy (LLLT) has been used as an effective therapeutic modality since the mid-1960s. Although there have been several clinical studies using LLLT in wound healing, especially diabetic, pressure and venous ulcers, there are few reports of using this technique in burn ulcers. Autologous fibroblast transplantation is a novel treatment for patients with burns or venous ulcers. In this study for the first time, we used LLLT along with autologous fibroblast skin transplantation to treat grade 3 burn ulcers in diabetic patients. This case series describes the successful management of grade 3 burn ulcers in 10 diabetic patients using autologous fibroblast transplantation along with LLLT. After the approval of the Tehran University Ethics Committee (IR.TUMS.REC.1394.1683) and the Iran Registry of Clinical Trials (IRCT2016050226069N3), 10 diabetic patients with 10 grade 3 burn ulcers, who were a candidate for skin graft surgery, entered the study. Donor skin was biopsied using a 3 mm punch. Fibroblasts were extracted and cultured in vitro in the GMP Technique laboratory. The patients were treated using LLLT in 3-4 weeks during the time that fibroblast cultures became ready to use. Laser irradiation was done using red light, 650 nm, 150 mW, 1 J/cm for the bed of the ulcer and infra-red light 808 nm, 200 mW, 6 J/cm for the margins every other day for 10 sessions. The mean wound size before treatment was 16.28 cm . All patients' burn wounds healed completely after 10-12 weeks. We conclude that this method can be used as an effective method for treating large wounds, especially in complicated patients including the diabetics.

摘要

自20世纪60年代中期以来,低强度激光疗法(LLLT)一直被用作一种有效的治疗方式。尽管已经有多项关于使用LLLT促进伤口愈合的临床研究,尤其是在糖尿病性溃疡、压疮和静脉性溃疡方面,但关于将该技术用于烧伤溃疡的报道却很少。自体成纤维细胞移植是一种针对烧伤或静脉性溃疡患者的新型治疗方法。在本研究中,我们首次将LLLT与自体成纤维细胞皮肤移植相结合,用于治疗糖尿病患者的Ⅲ度烧伤溃疡。本病例系列描述了10例糖尿病患者的Ⅲ度烧伤溃疡通过自体成纤维细胞移植联合LLLT成功治愈的情况。在获得德黑兰大学伦理委员会(IR.TUMS.REC.1394.1683)和伊朗临床试验注册中心(IRCT2016050226069N3)的批准后,10例患有10处Ⅲ度烧伤溃疡且适合进行皮肤移植手术的糖尿病患者进入了本研究。使用3毫米打孔器从供体皮肤上取活检组织。成纤维细胞被提取出来并在GMP技术实验室进行体外培养。在成纤维细胞培养准备好使用的3至4周时间内,对患者进行LLLT治疗。使用650纳米的红光,功率150毫瓦,能量密度1焦/平方厘米对溃疡创面进行激光照射,使用808纳米的红外光,功率200毫瓦,能量密度6焦/平方厘米对溃疡边缘每隔一天进行照射,共照射10次。治疗前创面的平均面积为16.28平方厘米。所有患者的烧伤创面在10至12周后均完全愈合。我们得出结论,该方法可作为治疗大面积伤口的有效方法,尤其是对于包括糖尿病患者在内的复杂患者。

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