Rezaei-Nejad Aida, Amirkhani Mohammad-Amir, Ebrahimi Alireza, Ghorani Seyyed-Mojtaba, Alamoutifard Emad, Nilforoushzadeh Mohammad-Ali, Mollapour-Sisakht Mahsa
Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Foot and Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Int J Low Extrem Wounds. 2023 Oct 13:15347346231204246. doi: 10.1177/15347346231204246.
Diabetic foot ulcers (DFUs) are classified as hard-to-heal wounds, which occur in approximately 15% of diabetic patients. Several interventions have shown efficacy in reducing the risk of amputation among patients with DFU, including timely diagnosis and management of infection and ischemia, debridement of necrotic tissues, reducing mechanical pressure on ulcers, and patient education. One major challenge in the management of DFUs is optimizing wound care to improve healing outcomes. Recently, interdisciplinary approaches proposed a new generation of wound dressing which increased efficacy and significantly decreased the healing time. The current study assessed the healing characteristics of chronic DFUs treated with lyophilized amniotic membrane gel (LAMG) in combination with standard care, versus a placebo hydrogel with standard care. In total, 18 patients (8 male, 10 female) were randomly assigned to the control group, which received standard care and a gelatin scaffold (placebo), or the intervention group, which received standard care along with LAMG. We evaluated the reduction in wound size and assessed the patient's health-related quality of life over 9 weeks. In the LAMG group (n = 9) and the Placebo group (n = 9), the wounds were reduced in size by a mean of 73.4% ± 15.3% and 13.1% ± 10.1%, respectively ( = .008). Patients treated with LAMG demonstrated significant improvements in the scores related to physical function, physical limitation, physical pain, general health, social function, emotional problems, and energy levels compared to the control group. The findings of this study indicate that using the LAMG with standard care significantly enhances wound healing.
糖尿病足溃疡(DFUs)被归类为难愈合伤口,约15%的糖尿病患者会出现此类伤口。多项干预措施已显示出在降低DFU患者截肢风险方面的有效性,包括及时诊断和处理感染与缺血、清除坏死组织、减轻溃疡部位的机械压力以及对患者进行教育。DFU管理中的一个主要挑战是优化伤口护理以改善愈合效果。最近,跨学科方法提出了新一代伤口敷料,其提高了疗效并显著缩短了愈合时间。本研究评估了冻干羊膜凝胶(LAMG)联合标准护理与安慰剂水凝胶联合标准护理治疗慢性DFUs的愈合特征。总共18名患者(8名男性,10名女性)被随机分配到对照组,接受标准护理和明胶支架(安慰剂),或干预组,接受标准护理加LAMG。我们评估了伤口大小的减小情况,并在9周内评估了患者与健康相关的生活质量。在LAMG组(n = 9)和安慰剂组(n = 9)中,伤口大小平均分别减小了73.4%±15.3%和13.1%±10.1%(P = 0.008)。与对照组相比,接受LAMG治疗的患者在身体功能、身体限制、身体疼痛、总体健康、社会功能、情绪问题和能量水平相关评分上有显著改善。本研究结果表明,LAMG联合标准护理可显著促进伤口愈合。