Jansen Theresa M, Janßen Sarah, Bölke Edwin, Homey Bernhard, Hoff Norman-Philipp
Department of Dermatology, Medical Faculty and University Hospital Düsseldorf Heinrich Heine University Düsseldorf Düsseldorf Germany.
Department of Radiotherapy and Radiooncology, Medical Faculty and University Hospital Düsseldorf Heinrich Heine University Düsseldorf Düsseldorf Germany.
Health Sci Rep. 2024 Aug 13;7(8):e2319. doi: 10.1002/hsr2.2319. eCollection 2024 Aug.
Chronic wounds present a growing challenge in the aging population, resulting in an extended course of treatment and an increased influx of patients with recalcitrant wounds seeking admission to hospitals. Furthermore, the general trend in patient care is toward simple and inexpensive treatment methods, feasible in an outpatient setting with little material costs. This retrospective case study aims to elucidate the operative procedure and outcomes associated with hair follicle unit transplantation utilizing punch grafts from the scalp for the management of hard-to-heal wounds.
A cohort of 28 patients, comprising 20 males and eight females, with a mean age of 72.61 years (range: 48-89) and an average wound area of 82.49 cm, underwent dissection of punch grafts containing hair follicles (2-3 mm in diameter) from the scalp. Subsequently, these grafts were transplanted into the wound bed. The retrospective evaluation of ulcer healing encompassed photo documentation and clinical records, while patient satisfaction was assessed through structured questionnaires.
In 78.6% (22) of the cases, a favorable impact on wound healing was observed, characterized by epithelization, and in 57.1% (16) of the patients, complete wound closure was achieved. With the exception of one donor site, all other sites healed without complications. The patient survey indicated that the majority of individuals subjected to the procedure did not perceive it as painful or time-consuming. Notably, 81% (17) of individuals expressed a willingness to undergo the treatment again. Even in challenging wound conditions, such as pyoderma gangrenosum, our method demonstrated a positive effect on wound healing.
Within our cohort, the utilization of hair follicle units in the management of hard-to-heal wounds resulted in either complete or partial wound closure for the majority of patients, accompanied by minimal morbidity, reduced operation time, and a low incidence of complications and associated costs.
慢性伤口给老龄化人口带来了日益严峻的挑战,导致治疗过程延长,顽固性伤口患者涌入医院的数量增加。此外,患者护理的总体趋势是采用简单且廉价的治疗方法,这种方法在门诊环境中可行且材料成本低。本回顾性病例研究旨在阐明利用头皮打孔移植毛囊单位治疗难愈合伤口的手术过程及结果。
28例患者组成的队列,其中男性20例,女性8例,平均年龄72.61岁(范围:48 - 89岁),平均伤口面积82.49平方厘米,接受了从头皮切取含毛囊的打孔移植物(直径2 - 3毫米)的手术。随后,将这些移植物移植到伤口床。对溃疡愈合的回顾性评估包括照片记录和临床记录,同时通过结构化问卷评估患者满意度。
78.6%(22例)的病例观察到对伤口愈合有积极影响,表现为上皮化,57.1%(16例)的患者实现了伤口完全闭合。除一个供区外,所有其他供区均无并发症愈合。患者调查表明,接受该手术的大多数人并不觉得手术痛苦或耗时。值得注意的是,81%(17例)的人表示愿意再次接受该治疗。即使在诸如坏疽性脓皮病等具有挑战性的伤口情况下,我们的方法对伤口愈合也显示出积极效果。
在我们的队列中,利用毛囊单位治疗难愈合伤口使大多数患者实现了完全或部分伤口闭合,同时发病率极低、手术时间缩短、并发症及相关成本发生率低。