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胎盘衍生生物材料与标准护理用于慢性糖尿病足溃疡愈合的比较:一项系统评价和荟萃分析。

Placenta-derived biomaterials vs. standard care in chronic diabetic foot ulcer healing: A systematic review and meta-analysis.

作者信息

Ruiz-Muñoz Maria, Martinez-Barrios Francisco-Javier, Lopezosa-Reca Eva

机构信息

Department Nursing and Podiatry. Faculty of Health Sciences. University of Málaga, Malaga, Spain.

出版信息

Diabetes Metab Syndr. 2025 Jan;19(1):103170. doi: 10.1016/j.dsx.2024.103170. Epub 2024 Dec 10.

Abstract

INTRODUCTION

This study explored the effectiveness of current placenta-derived biomaterials therapies in ulcer healing in DFU compared to standard of care (SOC).

METHODS

The systematic review and meta-analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. The electronic databases of PubMed, EMBASE, and Web of Science (WoS) internet were searched for the outcome rate of complete ulcer healing. The risk of bias assessment was conducted using the tool recommended by the Cochrane Collaboration. Statistical analysis included the individual and combined result of the studies, heterogeneity test, the effect size, sensitivity analysis, and publication bias tests.

RESULTS

Twelve randomized controlled trials (RCTs) with a total of 833 patients were included in this study. This meta-analysis showed a higher rate of complete ulcer healing in groups receiving placenta-derived biomaterials therapies (OR = 6.247 [4.425, 8.819], p < 0.01, I = 41 %) compared to control groups.

CONCLUSION

Placenta-derived biomaterials therapies have been shown to be more effective for achieving complete ulcer healing compared to current conventional treatments in DFU.

IMPLICATIONS FOR CLINICAL PRACTICE

The utilization of placenta-derived biomaterials in therapies for wound healing, particularly in chronic DFU, presents promising implications for clinical practice. These biomaterials offer a rich source of growth factors, cytokines, and extracellular matrix components, which can stimulate tissue regeneration and angiogenesis. Incorporating such therapies into clinical practice holds the potential to accelerate wound closure, reduce infection rates, and improve overall healing outcomes in people with diabetic chronic foot ulcers. Furthermore, the availability of these biomaterials can offer clinicians a readily-accessible and cost-effective alternative to traditional wound care approaches, ultimately enhancing patient care and quality of life. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

摘要

引言

本研究探讨了与标准治疗(SOC)相比,目前胎盘来源生物材料疗法在糖尿病足溃疡(DFU)愈合中的有效性。

方法

按照系统评价和Meta分析的首选报告项目(PRISMA)标准进行系统评价和Meta分析。在PubMed、EMBASE和科学网(WoS)互联网电子数据库中搜索完全溃疡愈合的结局率。使用Cochrane协作网推荐的工具进行偏倚风险评估。统计分析包括研究的个体和合并结果、异质性检验、效应大小、敏感性分析和发表偏倚检验。

结果

本研究纳入了12项随机对照试验(RCT),共833例患者。该Meta分析显示,与对照组相比,接受胎盘来源生物材料疗法的组完全溃疡愈合率更高(OR = 6.247 [4.425, 8.819],p < 0.01,I = 41%)。

结论

与目前DFU的传统治疗相比,胎盘来源生物材料疗法在实现完全溃疡愈合方面更有效。

对临床实践的启示

胎盘来源生物材料在伤口愈合治疗中的应用,特别是在慢性DFU中,对临床实践具有广阔的前景。这些生物材料提供了丰富的生长因子、细胞因子和细胞外基质成分来源,可刺激组织再生和血管生成。将此类疗法纳入临床实践有可能加速伤口闭合、降低感染率,并改善糖尿病慢性足溃疡患者的整体愈合结局。此外,这些生物材料的可用性可为临床医生提供一种易于获取且具有成本效益的传统伤口护理方法替代方案,最终提高患者护理水平和生活质量。本研究未获得公共、商业或非营利部门资助机构的任何特定资助。

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