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人工真皮治疗腿部溃疡的评估:一项探索性研究的临床结果

Evaluation of Artificial Dermis for the Treatment of Leg Ulcers: Clinical Outcomes From an Exploratory Study.

作者信息

Casoli Vincent, De Luca Laura, Desnouveaux Emilie, Demiri Efterpi, Battaglia Fabiana, Stagno d'Alcontres Francesco, Delia Gabriele

机构信息

Service de Chirurgie Plastique Reconstructrice et esthétique, CFX MICHELET CHU de Bordeaux, Université de Bordeaux, Bordeaux, France.

Papageorgiou Hospital (Department of Plastic Surgery), Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Int Wound J. 2025 Aug;22(8):e70739. doi: 10.1111/iwj.70739.

Abstract

Chronic leg ulcers present a significant clinical challenge due to their prolonged healing time and high recurrence rates. This prospective, multi-centre, non-randomised, observational study investigated the efficacy of a dermal regeneration template in improving skin graft integration for chronic leg ulcer treatment. Thirty patients were enrolled, with a control group receiving only skin grafts to evaluate the additional benefits of the template. Patients were assessed for pain levels, healing rates, wound retraction, pruritus, dressing type, analgesic use, complications, surgeon-evaluated wound recovery using the Vancouver scale, quality of life through the EuroQol questionnaire and photographic wound documentation. At 18 months, 70.0% of patients achieved at least a 50% reduction in wound surface area and 56.7% experienced complete wound closure. Significant improvements were observed in pain and discomfort (p = 0.0125), mobility (p = 0.0267), pain levels (p = 0.0340), vascularity (p = 0.0275) and overall wound reduction (p = 0.0368). The control group demonstrated lower wound reduction and complete healing rates, reinforcing the superior effectiveness of the dermal regeneration template in combination with skin grafting. This study highlights the potential of this approach to accelerate wound healing, reduce patient discomfort and enhance quality of life compared to traditional skin grafting alone.

摘要

慢性腿部溃疡因其愈合时间长和复发率高而带来了重大的临床挑战。这项前瞻性、多中心、非随机的观察性研究调查了一种真皮再生模板在改善慢性腿部溃疡治疗中皮肤移植融合方面的疗效。招募了30名患者,设立了一个仅接受皮肤移植的对照组以评估该模板的额外益处。对患者进行了疼痛程度、愈合率、伤口收缩、瘙痒、敷料类型、镇痛药物使用、并发症、使用温哥华量表由外科医生评估的伤口恢复情况、通过欧洲五维度健康量表问卷评估的生活质量以及伤口照片记录等方面的评估。在18个月时,70.0%的患者伤口表面积至少减少了50%,56.7%的患者伤口完全愈合。在疼痛和不适(p = 0.0125)、活动能力(p = 0.0267)、疼痛程度(p = 0.0340)、血管形成(p = 0.0275)和整体伤口缩小(p = 0.0368)方面观察到了显著改善。对照组的伤口缩小和完全愈合率较低,这进一步证明了真皮再生模板与皮肤移植相结合的卓越有效性。与单纯传统皮肤移植相比,本研究突出了这种方法在加速伤口愈合、减轻患者不适和提高生活质量方面的潜力。

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