Division of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Professional Education and Research Institute, Roanoke, Virginia, USA.
Int Wound J. 2022 Aug;19(5):1197-1209. doi: 10.1111/iwj.13715. Epub 2022 Jan 9.
Diabetic foot infections continue to be a major challenge for health care delivery systems. Following encouraging results from a pilot study using a novel purified reconstituted bilayer matrix (PRBM) to treat chronic diabetic foot ulcers (DFUs), we designed a prospective, multi-centre randomised trial comparing outcomes of PRBM at 12 weeks compared with a standard of care (SOC) using a collagen alginate dressing. The primary endpoint was percentage of wounds closed after 12 weeks. Secondary outcomes included assessments of complications, healing time, quality of life, and cost to closure. Forty patients were included in an intent-to-treat (ITT) and per-protocol (PP) analysis, with 39 completing the study protocol (n = 19 PRBM, n = 20 SOC). Wounds treated with PRBM were significantly more likely to close than wounds treated with SOC (ITT: 85% vs 30%, P = .0004, PP: 94% vs 30% P = .00008), healed significantly faster (mean 37 days vs 67 days for SOC, P = .002), and achieved a mean wound area reduction within 12 weeks of 96% vs 8.9% for SOC. No adverse events (AEs) directly related to PRBM treatment were reported. Mean PRBM cost of healing was $1731. Use of PRBM was safe and effective for treatment of chronic DFUs.
糖尿病足感染仍然是医疗保健系统面临的重大挑战。在一项使用新型纯化再构成双层基质 (PRBM) 治疗慢性糖尿病足溃疡 (DFU) 的试点研究取得令人鼓舞的结果后,我们设计了一项前瞻性、多中心随机试验,比较了 PRBM 与使用胶原藻酸盐敷料的标准治疗 (SOC) 在 12 周时的治疗结果。主要终点是 12 周后伤口闭合的百分比。次要结局包括并发症评估、愈合时间、生活质量和愈合成本。40 例患者纳入意向治疗 (ITT) 和方案 (PP) 分析,39 例完成研究方案 (n = 19 PRBM,n = 20 SOC)。接受 PRBM 治疗的伤口比 SOC 治疗的伤口更有可能闭合 (ITT:85%比 30%,P = 0.0004,PP:94%比 30%,P = 0.00008),愈合速度显著更快 (平均 37 天比 SOC 的 67 天,P = 0.002),并且在 12 周内伤口面积缩小 96%,而 SOC 为 8.9%。未报告与 PRBM 治疗直接相关的不良事件 (AE)。PRBM 治疗的平均愈合成本为 1731 美元。PRBM 用于治疗慢性 DFU 是安全有效的。