Aburn Rebecca, Chaffin Abigail E, Bosque Brandon A, Frampton Christopher, Dempsey Sandi G, Young D Adam, May Barnaby C H, Bohn Gregory A, Melin M Mark
Healthcare New Zealand, Richmond, New Zealand.
Division of Plastic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Int Wound J. 2025 Apr;22(4):e70368. doi: 10.1111/iwj.70368.
Venous leg ulcers (VLUs) are traditionally managed with standard-of-care dressings, compression and appropriate adjunctive venous interventions for pathologic venous reflux. Due to pathophysiological complexity and underlying patient comorbidities, conducting randomised controlled trials to evaluate the comparative efficacy of advanced treatment modalities is difficult, as many patients would likely be excluded. This retrospective, pragmatic, real-world evidence (RWE) study compared the healing outcomes of VLUs treated with either ovine forestomach matrix (OFM) (n = 312) or collagen/oxidised regenerated cellulose (ORC) (n = 239) in outpatient wound care centres. Unlike restrictive randomised controlled trials, minimal inclusion and exclusion criteria were applied to create two treatment cohorts that reflected the general VLU population. The incidence (%) of closure was greater in OFM-treated VLUs at 12, 24 and 36 weeks, and this difference was significant at 24 and 36 weeks compared to collagen/ORC. Median time to wound closure was significantly faster (p = 0.045) in the OFM cohort (11.1 ± 0.6 weeks) compared to the collagen/ORC group (12.3 ± 1.0 weeks). Cox proportional hazards analysis demonstrated that OFM-treated VLUs had a significantly greater probability of healing (up to ~40%). This RWE comparative efficacy study further substantiates the clinical benefit of OFM in the treatment of chronic wounds, such as VLU, in a real-world patient cohort.
传统上,下肢静脉溃疡(VLUs)的治疗采用标准护理敷料、加压包扎以及针对病理性静脉反流的适当辅助静脉干预措施。由于病理生理复杂性和患者潜在的合并症,开展随机对照试验以评估先进治疗方式的比较疗效很困难,因为许多患者可能会被排除在外。这项回顾性、实用性、真实世界证据(RWE)研究比较了在门诊伤口护理中心接受羊前胃基质(OFM)治疗(n = 312)或胶原/氧化再生纤维素(ORC)治疗(n = 239)的VLUs的愈合结果。与严格的随机对照试验不同,该研究采用了极少的纳入和排除标准来创建两个反映一般VLU患者群体的治疗队列。在12周、24周和36周时,接受OFM治疗的VLUs的愈合率(%)更高,与胶原/ORC相比,在24周和36周时这种差异具有统计学意义。与胶原/ORC组(12.3±1.0周)相比,OFM队列的伤口愈合中位时间显著更快(p = 0.045)(11.1±0.6周)。Cox比例风险分析表明,接受OFM治疗的VLUs愈合的可能性显著更高(高达约40%)。这项RWE比较疗效研究进一步证实了OFM在真实世界患者队列中治疗慢性伤口(如VLU)的临床益处。