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应用冷冻保存的人羊膜治疗继发于钙磷沉积症的皮肤溃疡。

Use of cryopreserved human amniotic membrane in the treatment of skin ulcers secondary to calciphylaxis.

机构信息

Department of Plastic Surgery and Burns Unit, Clinical University Hospital "Virgen de la Arrixaca", Biomedical Research Institute of Murcia ("Instituto Murciano de Investigación Biosanitaria", IMIB), Murcia, Spain.

Department of General Surgery, Complex wounds and Diabetic Foot Unit, Clinical University "Hospital Virgen de la Arrixaca", Biomedical Research Institute of Murcia ("Instituto Murciano de Investigación Biosanitaria", IMIB), Murcia, Spain.

出版信息

Dermatol Ther. 2021 Mar;34(2):e14769. doi: 10.1111/dth.14769. Epub 2021 Jan 18.

Abstract

Calciphylaxis is a rare condition characterized by skin ulceration and necrosis as a result of vascular calcification of the small and medium blood vessels of skin and subcutaneous tissues. It mainly occurs in patients with advanced chronic kidney disease and sometimes leads to complications with a fatal outcome. In this report, we describe the case of a 67-year-old male patient with end stage renal disease presenting painful skin ulcers on his lower limbs. The lesions had progressively grown and were associated to severe pain and decreased quality of life. The ulcers did not respond to conventional treatments and the patient underwent skin biopsy of these lesions obtaining anatomopathological findings compatible with calciphylaxis. In this report, we present an innovative treatment for skin ulcers secondary to calciphylaxis using cryopreserved amniotic membrane (AM) as a dressing in order to promote epithelialization of the wounds. After four applications, healing of the main ulcer and reduction in pain was achieved. In summary, applying cryopreserved AM probed to be a promising strategy to reduce pain and to enhance epithelialization and healing of chronic non-responsive ulcers in calciphylaxis.

摘要

钙化防御是一种罕见的疾病,其特征是皮肤溃疡和坏死,是由于皮肤和皮下组织中小血管和中等大小血管的钙化所致。它主要发生在晚期慢性肾脏病患者中,有时会导致并发症,导致致命的后果。在本报告中,我们描述了一例 67 岁男性终末期肾病患者,其下肢出现疼痛性皮肤溃疡。这些病变逐渐增大,并伴有严重疼痛和生活质量下降。溃疡对常规治疗无反应,患者接受了这些病变的皮肤活检,获得了与钙化防御一致的解剖病理发现。在本报告中,我们提出了一种使用冷冻保存羊膜 (AM) 作为敷料治疗继发于钙化防御的皮肤溃疡的创新方法,以促进伤口上皮化。经过四次应用,主要溃疡愈合,疼痛减轻。总之,应用冷冻保存 AM 被证明是一种很有前途的策略,可以减轻疼痛,促进上皮化和钙化防御中慢性无反应性溃疡的愈合。

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