St John's Innovation Centre, Cambridge, UK.
Clinical Innovation Cardiff, Cardiff, Wales.
Int Wound J. 2020 Jun;17(3):742-752. doi: 10.1111/iwj.13293. Epub 2020 Feb 26.
Venous leg ulcers (VLUs) have a significant impact on approximately 3% of the adult population worldwide, with a mean NHS wound care cost of £7600 per VLU over 12 months. The standard care for VLUs is compression therapy, with a significant number of ulcers failing to heal with this treatment, especially with wound size being a risk factor for non-healing. This multicentre, prospective, randomised trial evaluated the safety and effectiveness of autologous skin cell suspension (ASCS) combined with compression therapy compared with standard compression alone (Control) for the treatment of VLUs. Incidence of complete wound closure at 14 weeks, donor site closure, pain, Health-Related Quality of Life (HRQoL), satisfaction, and safety were assessed in 52 patients. At Week 14, VLUs treated with ASCS + compression had a statistically greater decrease in ulcer area compared with the Control (8.94 cm versus 1.23 cm , P = .0143). This finding was largely driven by ulcers >10 to 80 cm in size, as these ulcers had a higher mean percentage of reepithelialization at 14 weeks (ASCS + compression: 69.97% and Control: 11.07%, P = .0480). Additionally, subjects treated with ASCS + compression experienced a decrease in pain and an increase in HRQoL compared with the Control. This study indicates that application of ASCS + compression accelerates healing in large venous ulcers.
静脉性腿部溃疡(VLUs)在全球约 3%的成年人中具有显著影响,每个 VLU 在 12 个月内的国民保健制度(NHS)伤口护理费用平均为 7600 英镑。VLUs 的标准治疗是压迫疗法,但有相当数量的溃疡无法通过这种治疗治愈,尤其是伤口大小是愈合不良的一个风险因素。这项多中心、前瞻性、随机试验评估了自体皮肤细胞悬浮液(ASCS)联合压迫疗法与单独标准压迫疗法(对照)治疗 VLUs 的安全性和有效性。在 52 名患者中评估了 14 周时完全伤口闭合、供体部位闭合、疼痛、健康相关生活质量(HRQoL)、满意度和安全性的发生率。在第 14 周时,与对照组相比,接受 ASCS+压迫治疗的 VLU 溃疡面积有统计学上的显著减小(8.94cm 与 1.23cm,P =.0143)。这一发现主要归因于大小在 10 到 80cm 之间的溃疡,因为这些溃疡在第 14 周时有更高的平均再上皮化百分比(ASCS+压迫组:69.97%,对照组:11.07%,P =.0480)。此外,与对照组相比,接受 ASCS+压迫治疗的患者疼痛减轻,HRQoL 提高。这项研究表明,应用 ASCS+压迫可加速大型静脉性溃疡的愈合。