Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul National University Hospital, Seoul, Korea.
Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Seoul, Korea.
J Wound Care. 2021 May 2;30(5):414-418. doi: 10.12968/jowc.2021.30.5.414.
The extracellular matrix (ECM) is one of the most important elements in wound healing. Absence or dysfunction of the ECM may impair wound healing. The application of acellular dermal matrix (ADM) as a substitute for ECM has been suggested. This study investigated the clinical application and wound healing effects of a paste-type ADM in patients presenting with hard-to-heal wounds due to various causes.
Patients with a hard-to-heal wound for >1 month, from September 2017 to February 2019, were included in this study. After debridement, the paste-type ADM was applied, at zero (baseline), two and four weeks. After application of the paste-type ADM, a conventional dressing was applied using polyurethane foam. Wound size, the formation of granulation tissue, re-epithelialisation, complete healing and adverse events were recorded at zero (baseline), one, two, four, eight and 12 weeks after the initial treatment.
A total of 18 patients took part (eight male, 10 female, mean age of 56±16.16 years). The mean wound area decreased from 17.42±10.04cm to 12.73±7.60cm by week one (p<0.05), to 10.16±7.00 by week two (p<0.0005), to 5.56±5.25 by week four (p<0.0001), to 2.77±5.15 by week eight (p<0.0001) and to 2.07±4.78 by week 12 (p<0.0001). The number of patients with >75% re-epithelialisation increased from two (11.1%) at two weeks to five (27.8%) at four weeks, to 11 (61.1%) at eight weeks and to 13 (72.2%) at 12 weeks. The number of patients showing complete wound healing was two (11.1%) at four weeks, nine (50.0%) at eight weeks and 12 (66.7%) at 12 weeks. No adverse events were reported during treatment.
The paste-type ADM used in this study is a viable option for facilitating wound healing; it can shorten hospitalisation, and promote a faster recovery and return to normal life activities.
细胞外基质（ECM）是伤口愈合最重要的因素之一。ECM 的缺失或功能障碍可能会影响伤口愈合。已提出使用去细胞真皮基质（ADM）作为 ECM 的替代品。本研究调查了在由于各种原因导致难以愈合的伤口的患者中应用糊剂型 ADM 的临床应用和伤口愈合效果。
纳入 2017 年 9 月至 2019 年 2 月间患有>1 个月的难以愈合的伤口的患者。清创后，将糊剂型 ADM 应用于零（基线）、两和四周。应用糊剂型 ADM 后，使用聚氨酯泡沫敷料进行常规敷料。在初始治疗后零（基线）、一、二、四、八和十二周时记录伤口大小、肉芽组织形成、上皮再形成、完全愈合和不良事件。
共有 18 名患者参与（8 名男性，10 名女性，平均年龄 56±16.16 岁）。平均伤口面积从第 1 周的 17.42±10.04cm 减少到第 1 周的 12.73±7.60cm（p<0.05），第 2 周的 10.16±7.00cm（p<0.0005），第 4 周的 5.56±5.25cm（p<0.0001），第 8 周的 2.77±5.15cm（p<0.0001）和第 12 周的 2.07±4.78cm（p<0.0001）。>75%上皮再形成的患者人数从第 2 周的 2 名（11.1%）增加到第 4 周的 5 名（27.8%），第 8 周的 11 名（61.1%）和第 12 周的 13 名（72.2%）。第 4 周有 2 名（11.1%）患者完全愈合，第 8 周有 9 名（50.0%）患者完全愈合，第 12 周有 12 名（66.7%）患者完全愈合。治疗期间未发生不良反应。
本研究中使用的糊剂型 ADM 是促进伤口愈合的可行选择；它可以缩短住院时间，促进更快的恢复和回归正常的生活活动。
