胎盘膜同种异体移植物在慢性伤口中的临床应用和结果的回顾性分析。

A Retrospective Analysis of Clinical Use and Outcomes Using Viable Placental Membrane Allografts in Chronic Wounds.

机构信息

Froedtert and the Medical College Community Hospital Division, Menomonee Falls, Wisconsin; Clinical Translational Science Institute of Southeastern Wisconsin, Milwaukee, Wisconsin.

出版信息

Wounds. 2021 Dec;33(12):329-333.

PMID:34882575

Abstract

INTRODUCTION

Viable placental membrane (vPM) has been shown to decrease time to healing, adverse wound events, and wound-related infections. Wound research exclusion criteria commonly exclude wound types other than diabetic foot ulcers and venous leg ulcers (VLUs), comorbidities including peripheral arterial disease (PAD) and uncontrolled diabetes mellitus (DM), and wounds with exposed bone or tendon.

OBJECTIVE

This retrospective research study evaluated the clinical use and outcomes of the vPM with living mesenchymal stem cells used in chronic wound management in the community hospital outpatient department setting with the goal of comparing real-world use and outcomes of the product with use and outcomes described in the chronic wound literature.

MATERIALS AND METHODS

A retrospective analysis on vPM treatments at a Wisconsin academic health system's community hospitals. Participants included all patients who received vPM therapy between July 1, 2016, and August 21, 2019.

RESULTS

A total of 89 patients received vPM treatment during the study period (mean age, 70 years; 69% male [n = 61], 31% female [n = 28]). Wound types were 54% diabetic or neuropathic foot ulcers (n = 48), 17% VLUs (n = 15), 7% pressure injuries (n = 6), and 22% atypical wounds (n = 20). The average wound duration prior to vPM initiation was 104 days. Average wound size at presentation was 6.9 cm2. Of study participants 54% had PAD (n = 48), 63% had DM (n = 56), 33.7% had DM and PAD (n = 30), and 17% had exposed bone or tendon (n = 15). Average adjusted time to healing after initiation of vPM was 81.2 days. The percentage of wounds healed 12 weeks after initiation of vPM treatment was 57%.

CONCLUSIONS

Effectiveness of vPM observed in controlled trials also was observed in this real-world study on vPM for multiple wound types, patients with comorbidities including PAD and uncontrolled DM, and wounds with exposed bone or tendon. Results of this study were not statistically different from those reported in the literature. More randomized controlled trials are needed to explore the efficacy of vPM on patient presentations common to wound healing centers.

摘要

简介

已证实，活性胎盘膜（vPM）可缩短愈合时间，减少不良伤口事件和与伤口相关的感染。伤口研究排除标准通常排除除糖尿病足溃疡和静脉小腿溃疡（VLU）以外的伤口类型，合并症包括外周动脉疾病（PAD）和未控制的糖尿病（DM），以及有暴露骨或肌腱的伤口。

目的

本回顾性研究评估了活间充质干细胞的 vPM 在社区医院门诊环境中用于慢性伤口管理的临床应用和结果，目的是比较该产品的真实世界应用和结果与慢性伤口文献中描述的应用和结果。

材料和方法

对威斯康星州学术健康系统的社区医院使用 vPM 治疗的回顾性分析。参与者包括 2016 年 7 月 1 日至 2019 年 8 月 21 日期间接受 vPM 治疗的所有患者。

结果

在研究期间，共有 89 名患者接受了 vPM 治疗（平均年龄 70 岁；69%为男性[61 例]，31%为女性[28 例]）。伤口类型为 54%糖尿病或神经病变性足部溃疡（48 例），17% VLU（15 例），7%压力性损伤（6 例）和 22%非典型伤口（20 例）。在开始使用 vPM 之前，伤口的平均持续时间为 104 天。就诊时的平均伤口大小为 6.9cm2。研究参与者中有 54%（48 例）患有 PAD，63%（56 例）患有 DM，33.7%（30 例）患有 DM 和 PAD，17%（15 例）患有暴露骨或肌腱。开始使用 vPM 后，平均愈合时间为 81.2 天。开始 vPM 治疗后 12 周，伤口愈合率为 57%。