Keck School of Medicine, University of Southern California, California, Los Angeles, USA.
Brigham and Women's Hospital, Boston, Massachusetts, USA.
Int Wound J. 2020 Oct;17(5):1366-1375. doi: 10.1111/iwj.13404. Epub 2020 May 26.
Diabetic foot ulcers (DFUs) are a growing burden on patients and health care systems that often require multiple treatments of both conventional and advanced modalities to achieve complete wound closure. A novel autologous homologous skin construct (AHSC) has been developed to treat cutaneous defects with a single topical application, by leveraging the endogenous repair capabilities of the patient's healthy skin. The AHSC's ability to close DFUs with a single treatment was evaluated in an open-label, single-arm feasibility study. Eleven patients with DFUs extending up to tendon, bone, or capsule received a single topical application of AHSC. Closure was documented weekly with high-resolution digital photography and wound planimetry. All 11 DFUs demonstrated successful graft take. Ten DFUs closed within 8 weeks. The median time-to-complete closure was 25 days. The mean percent area reduction for all 11 wounds at 4 weeks was 83%. There were no adverse events related to the AHSC treatment site. This pilot study demonstrated AHSC may be a viable single application topical intervention for DFUs and warrants investigation in larger, controlled studies.
糖尿病足溃疡 (DFUs) 给患者和医疗保健系统带来了日益沉重的负担,这些患者通常需要多次接受传统和先进治疗方法的治疗,才能实现完全愈合。一种新型的自体同源皮肤构建物 (AHSC) 已经被开发出来,通过利用患者健康皮肤的内在修复能力,只需单次局部应用即可治疗皮肤缺损。一项开放性、单臂可行性研究评估了 AHSC 单次治疗 DFUs 的能力。11 名患有 DFUs 至肌腱、骨骼或囊的患者接受了单次 AHSC 局部应用。每周通过高分辨率数字摄影和伤口平面测量记录闭合情况。所有 11 例 DFUs 均显示成功移植。10 例 DFUs 在 8 周内闭合。完全闭合的中位时间为 25 天。所有 11 例伤口在 4 周时的平均面积减少百分比为 83%。没有与 AHSC 治疗部位相关的不良事件。这项初步研究表明,AHSC 可能是一种可行的 DFUs 单次局部应用干预措施,值得在更大的对照研究中进一步研究。