Medical Nursing and Rehibilitation Center, Beit Hadar, Ashdod, Israel.
Surgical Wound Care Services, Cuyahoga Falls, Ohio, USA.
Int Wound J. 2023 Mar;20(3):806-812. doi: 10.1111/iwj.13927. Epub 2022 Aug 23.
Management and treatment of pressure ulcers (PUs) are met with great difficulty due to various factors that cause vulnerability of the soft tissue such as location, limited mobility, increased friction and shearing forces, as well as other comorbidities that may delay or halt wound healing. The topical autologous blood clot therapy (TABCT) is a point-of-care treatment used as a blood clot to assist in recreating and repairing the extracellular matrix (ECM). The mechanism of action consists of reconstruction of the ECM by incorporating into the ulcer, providing protection from further external destruction, while assisting in advancement through the wound healing phases via interaction of necessary growth factors, mediators, and chemokines. This study aims to assess the efficacy of the TABCT in the treatment of PUs in comparison to standard of care (SOC) treatment. Twenty-four patients, 18 years or older, with PUs ranging from stage 1 to 4, were included in this study. TABCT was created by using the patient's own peripheral blood in a point of care setting. Efficacy in percent area reduction (PAR) on weeks 4 and 12 with TABCT over SOC was assessed. Treatment using TABCT in PUs resulted in 77.9% of the patients achieving a 50% PAR on week 4. The mean PAR on week 12 was 96.23% with 45% of the wounds treated with TABCT achieving complete wound closure. TABCT exhibited efficacy in PAR of PUs. In addition, TABCT use prompted granulation tissue formation over vital structures, such as bone, which is often present in later stage PUs. The potential of bringing an affordable, cost-effective, advanced biologic bedside treatment that is efficacious in resolution of these complex wounds has the potential to drastically reduce the burden of treatment on the health system.
由于各种因素导致软组织脆弱，如位置、活动受限、摩擦力和剪切力增加，以及其他可能延迟或阻止伤口愈合的合并症，压力性溃疡（PU）的管理和治疗极具挑战性。局部自体血凝块疗法（TABCT）是一种即时治疗方法，用作血凝块来协助重建和修复细胞外基质（ECM）。作用机制包括通过整合到溃疡中来重建 ECM，提供免受进一步外部破坏的保护，同时通过必要的生长因子、介质和趋化因子的相互作用，协助通过伤口愈合阶段的进展。本研究旨在评估 TABCT 治疗压力性溃疡与标准治疗（SOC）的疗效比较。这项研究纳入了 24 名年龄在 18 岁及以上、患有 1 至 4 期压力性溃疡的患者。在即时治疗环境中使用患者自身外周血来制备 TABCT。在第 4 周和第 12 周，通过 TABCT 与 SOC 治疗比较评估疗效，以面积减少百分比（PAR）来表示。在压力性溃疡中使用 TABCT 治疗后，77.9%的患者在第 4 周达到 50%的 PAR。第 12 周的平均 PAR 为 96.23%，其中 45%的 TABCT 治疗的伤口完全闭合。TABCT 在压力性溃疡的 PAR 中表现出疗效。此外，TABCT 的使用促使肉芽组织在骨骼等重要结构上形成，这在后期压力性溃疡中很常见。将一种具有成本效益、先进的生物床边治疗方法用于治疗这些复杂的伤口，这种方法具有减轻医疗系统治疗负担的潜力。
