Frykberg Robert G, Tunyiswa Zwelithini
Open Wound Research Puyallup Washington USA.
Health Sci Rep. 2024 Jun 17;7(6):e2196. doi: 10.1002/hsr2.2196. eCollection 2024 Jun.
Diabetic foot ulcers are a severe complication in diabetic patients, significantly impact healthcare systems and patient quality of life, often leading to hospitalization and amputation. Traditional Standard of Care (SOC) treatments are inadequate for many patients, necessitating advanced wound care products (AWCPs) like human placental membranes. This study conducts a retrospective analysis to compare the effectiveness of two human placental membrane products, retention-processed amnion chorion (RE-AC) and lamination-processed amnion chorion (L-AC) in managing chronic diabetic foot ulcers (DFUs).
The study collected retrospective observational data from electronic health records (EHRs) of patients treated for DFU at three outpatient wound care centers. Patients were categorized into two cohorts based on the treatment received. Key metrics included wound size progression and the number of product applications. The analysis employed Bayesian estimation, utilizing an analysis of covariance model with a Hurdle Gamma likelihood.
We found that RE-AC achieved a marginally higher expected Percent Area Reduction (xPAR) in DFUs compared to L-AC at 12 weeks (67.3% vs. 52.6%). RE-AC also required fewer applications, suggesting greater efficiency in general wound closure. Probability of full wound closure was similar in both groups (0.738 vs 0.740 in RE-AC and L-AC, respectively).
The findings suggest that while L-AC might be slightly more effective in complete ulcer healing, RE-AC offers overall better treatment efficiency, especially in reducing the frequency of applications. This efficiency can lead to improved patient comfort, reduced treatment costs, and optimized resource utilization in healthcare settings.
糖尿病足溃疡是糖尿病患者的一种严重并发症,对医疗保健系统和患者生活质量有重大影响,常导致住院和截肢。传统的标准护理(SOC)治疗对许多患者来说并不充分,因此需要如人胎盘膜等先进伤口护理产品(AWCPs)。本研究进行了一项回顾性分析,以比较两种人胎盘膜产品,即保留处理羊膜绒毛膜(RE-AC)和分层处理羊膜绒毛膜(L-AC)在治疗慢性糖尿病足溃疡(DFUs)方面的有效性。
该研究从三个门诊伤口护理中心接受DFU治疗患者的电子健康记录(EHRs)中收集回顾性观察数据。根据接受的治疗将患者分为两个队列。关键指标包括伤口大小进展和产品应用次数。分析采用贝叶斯估计,利用带有障碍伽马似然性的协方差分析模型。
我们发现,与L-AC相比,RE-AC在12周时DFUs的预期面积减少百分比(xPAR)略高(分别为67.3%和52.6%)。RE-AC所需的应用次数也更少,表明在一般伤口闭合方面效率更高。两组完全伤口闭合的概率相似(RE-AC和L-AC分别为0.738和0.740)。
研究结果表明,虽然L-AC在完全溃疡愈合方面可能略有效,但RE-AC总体上提供了更好的治疗效率,特别是在减少应用频率方面。这种效率可以提高患者舒适度、降低治疗成本,并优化医疗环境中的资源利用。