Lehrman Jeffrey D
Foot and Ankle Specialists of Delaware County, Springfield, PA.
Wounds. 2020 Mar;32(3):E11-E13.
Diabetes affects 30 million children and adults in the United States, equivalent to 1 out of every 11 people in the country, and results in costs of $327 billion annually. Interventions that can improve healing rates and/or reduce the size of diabetic ulcers may lower the incidence of infection, rate of amputations, and cost of care. This report is on the use of a collagen wound contact layer in conjunction with negative pressure wound therapy (NPWT) to achieve healing in a chronic diabetic foot ulcer (DFU).
A known patient with type 1 diabetes presented with a chronic DFU of 6 months' duration. Previous treatment modalities included offloading regimens and topical therapies (ie, clostridial collagenase, human platelet-derived growth factors, and 6 applications of a human amniotic membrane allograft). A collagen wound contact layer was applied to the debrided wound bed with subsequent debridements performed every other week, weekly NPWT dressing changes, and weekly contact layer changes. A 91% reduction in wound area was seen at day 35, with complete healing at day 63, and no recurrence at 18 months.
The combination of a collagen wound contact layer and weekly NPWT had a significantly positive effect on healing in this chronic DFU. The regimen was well-tolerated and simple to administer in this case.
糖尿病影响着美国3000万儿童和成年人，相当于该国每11人中就有1人患病，每年造成的花费达3270亿美元。能够提高愈合率和/或缩小糖尿病溃疡面积的干预措施可能会降低感染发生率、截肢率和护理成本。本报告介绍了使用胶原蛋白伤口接触层结合负压伤口治疗（NPWT）来治愈慢性糖尿病足溃疡（DFU）的情况。
一名已知的1型糖尿病患者出现了持续6个月的慢性DFU。先前的治疗方法包括减压方案和局部治疗（即梭菌胶原酶、人血小板衍生生长因子，以及6次人羊膜同种异体移植）。将胶原蛋白伤口接触层应用于清创后的伤口床，随后每隔一周进行清创，每周更换NPWT敷料，每周更换接触层。在第35天时伤口面积减少了91%，在第63天时完全愈合，18个月时无复发。
胶原蛋白伤口接触层和每周一次的NPWT联合使用对该慢性DFU的愈合有显著的积极作用。在该病例中，该治疗方案耐受性良好且易于实施。
