Johnson Eric L, Saunders Molly, Thote Tanushree, Danilkovitch Alla
Bozeman Health Deaconess Hospital, Wound and Hyperbaric Center, Bozeman, MT.
Osiris Therapeutics, Columbia, MD.
Wounds. 2021 Feb;33(2):34-40.
Higher closure rates for chronic diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) have been reported for placental products adjunct to standard of care (SOC) vs SOC alone; however, data for other types of wounds are limited.
This study aimed to evaluate the clinical outcomes of amnion-derived and chorion-derived cryopreserved placental membranes containing viable cells (vCPM) in the treatment of nonhealing upper-extremity and lower-extremity wounds of nondiabetic and nonvenous pathophysiology. The authors hypothesized that treatment with vCPM adjunct to SOC would result in positive clinical outcomes for these wounds.
Data for all patients consecutively treated between January 2016 and May 2019 with vCPM adjunct to SOC were retrospectively collected and analyzed through chart review at a single center. Patients with wounds of diabetic and venous pathophysiology and patients receiving other skin substitutes during the course of vCPM treatment were excluded from the study. Outcomes included wound closure, time to closure, number of applications, and vCPM-related adverse events (AEs).
Ninety-two patients with 104 wounds received vCPM applications adjunct to SOC. The median wound size was 3.15 cm2 (mean, 12.7 cm2) with a median duration of 1.5 months (mean, 3.9 months). Eighty-seven of the 104 wounds (83.7%) achieved complete wound closure in a median time of 41 days and 3 applications of vCPM. There were no differences in closure rates between upper-extremity and lower-extremity wounds, nor between the amnion and chorion products. There were no vCPM-related adverse events.
This study provides valuable information to physicians, hospitals, and payers as it pertains to medically necessary and appropriate patient treatment.
据报道,与单独使用标准治疗(SOC)相比,在标准治疗基础上加用胎盘制品可提高慢性糖尿病足溃疡(DFU)和下肢静脉溃疡(VLU)的愈合率;然而,其他类型伤口的数据有限。
本研究旨在评估含有活细胞的羊膜和绒毛膜来源的冷冻保存胎盘膜(vCPM)在治疗非糖尿病、非静脉病理生理的上肢和下肢难愈合伤口中的临床疗效。作者假设,在标准治疗基础上加用vCPM治疗这些伤口将产生积极的临床疗效。
回顾性收集并分析了2016年1月至2019年5月在单一中心连续接受vCPM联合标准治疗的所有患者的数据,通过病历审查进行分析。患有糖尿病和静脉病理生理伤口的患者以及在vCPM治疗过程中接受其他皮肤替代物的患者被排除在研究之外。观察指标包括伤口愈合情况、愈合时间、应用次数以及与vCPM相关的不良事件(AE)。
92例患者的104处伤口接受了vCPM联合标准治疗。伤口中位面积为3.15平方厘米(平均12.7平方厘米),中位病程为1.5个月(平均3.9个月)。104处伤口中的87处(83.7%)在中位时间41天内实现完全愈合,平均应用3次vCPM。上肢和下肢伤口的愈合率以及羊膜和绒毛膜制品之间的愈合率均无差异。未发生与vCPM相关的不良事件。
本研究为医生、医院和支付方提供了有关必要且适当的患者治疗的有价值信息。