Thamm Oliver C, Eschborn Johannes, Zimmermann Lucas, Dekker Clara, Martin Hubert, Brockmann Michael, Zinser Max J, Fuchs Paul C
Clinic for Plastic and Reconstructive Surgery, Helios Hospital Berlin-Buch, Berlin, Germany.
Clinic for Plastic- and Reconstructive Surgery, Hand Surgery, Burn Care Center, University Witten/Herdecke, Cologne-Merheim Medical Center, Cologne, Germany.
Wound Repair Regen. 2023 Sep-Oct;31(5):663-670. doi: 10.1111/wrr.13111. Epub 2023 Aug 3.
Chronic wounds remain a therapeutic and financial challenge for physicians and the health care systems. Innovative, inexpensive and effective treatment methods would be of immense value. The sublesional fat grafting could be such treatment, although effectiveness and safety have only been assessed in a few randomised clinical trials. The fat graft was obtained by liposuction, washed with the Coleman method and then injected sublesional and into the wound margins after surgical debridement. For the control group, saline solution was used instead of fat. The primary endpoint was to determine the wound size reduction in both groups. The wounds were measured preoperatively, intraoperatively and 3, 7, 21 and 60 days after the intervention. A p-value of <0.05 was considered significant. Furthermore, histology and microbiology of the wounds and pain were assessed. A temporary effect of the treatment was observed after 14 and 21 days. The wound size reduction was significantly larger in the intervention group, whereas after 60 days, no significant difference was detected between both groups. No adverse events could be reported and the pain level was almost equal in the control and intervention group. Sublesional fat grafting temporarily enhanced healing of chronic wounds. The procedure was safe and the pain level was low. Repeated interventions could lead to complete wound closure, which should be determined in future studies.
慢性伤口对医生和医疗保健系统而言仍然是一个治疗和经济方面的挑战。创新、廉价且有效的治疗方法将具有巨大价值。病变下方脂肪移植可能就是这样一种治疗方法，尽管其有效性和安全性仅在少数随机临床试验中得到评估。脂肪移植物通过抽脂获取，采用科尔曼方法清洗，然后在手术清创后注入病变下方及伤口边缘。对于对照组，使用生理盐水替代脂肪。主要终点是确定两组伤口大小的减小情况。在术前、术中以及干预后3天、7天、21天和60天对伤口进行测量。p值<0.05被认为具有显著性。此外，还对伤口的组织学、微生物学和疼痛情况进行了评估。在14天和21天后观察到了该治疗的暂时效果。干预组伤口大小的减小明显更大，而在60天后，两组之间未检测到显著差异。未报告不良事件，且对照组和干预组的疼痛水平几乎相等。病变下方脂肪移植暂时促进了慢性伤口的愈合。该 procedure 是安全的，疼痛水平较低。重复干预可能导致伤口完全闭合，这一点应在未来研究中确定。 （注：原文中“procedure”未翻译，推测可能是前文提到的某种操作，因无更多信息暂保留英文）
