Use of homologous platelet gel to manage refractory diabetic lower extremity ulcers: additional experience at a tertiary hospital.

IF 1.4 4区医学 Q3 DERMATOLOGY Wounds : a compendium of clinical research and practice Pub Date : 2023-11-01

Sara Ferreira, Marco Sampaio, Margarida Oliveira, Francisco Dias, Eduarda Valente, Maria Luís Queirós, Rosa Guimarães, Joel Pereira, Helena Neto, Rui Carvalho, Marika Bini Antunes

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引用次数: 0

Abstract

Background: DLEUs are a major cause of morbidity. Appropriate treatment is essential, and newer methods to achieve ulcer healing have been described, including application of PG.

Objective: This study evaluated the effectiveness and safety of homologous PG in patients with chronic noninfected DLEU refractory to standard treatment as well as possible correlations between patient comorbidities and response to treatment.

Materials and methods: Data from patients with chronic refractory DLEU managed with homologous PG between January 2014 and October 2022 were evaluated (comorbidities, wound characteristics, number and time of treatment, outcome). Outcome was classified as complete response (complete ulcer healing with reepithelialization), partial response (≥50% reduction in area and/or improvement of pain), or absence of response. The chi-square test was used to compare groups, with alpha level set at less than .05.

Results: A total of 81 patients (63 male, 18 female; median age, 65 years; median HbA1c, 7.6%; median ulcer area, 2.9 cm2) were proposed for PG application. A total of 62 patients had 3 or more comorbidities. Outcome was evaluated in 69 patients, with response observed in 49% (complete, 32%; partial, 17%). Worse outcomes occurred in patients with polyneuropathy (chi-square statistic: 4.183; P = .041).

Conclusion: Homologous PG is a safe and possibly effective therapeutic alternative for DLEU that is unresponsive to standard therapies.

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使用同源血小板凝胶治疗难治性糖尿病下肢溃疡:在三级医院的额外经验。

背景:dleu是发病的主要原因。适当的治疗是必不可少的，新的方法来实现溃疡愈合已经被描述，包括应用PG。目的:本研究评估同源PG在慢性非感染性DLEU患者的有效性和安全性，以及患者合并症与治疗反应之间可能的相关性。材料和方法:对2014年1月至2022年10月间接受同源PG治疗的慢性难治性DLEU患者的数据进行评估(合并症、伤口特征、治疗次数和时间、结果)。结果分为完全缓解(溃疡完全愈合伴再上皮化)、部分缓解(面积缩小≥50%和/或疼痛改善)或无缓解。组间比较采用卡方检验，α水平设为小于0.05。结果:共81例患者，其中男63例，女18例;中位年龄65岁;中位HbA1c为7.6%;溃疡中位面积2.9 cm2)建议应用PG。共有62例患者有3种或3种以上合并症。对69例患者的结果进行了评估，49%的患者观察到缓解(完全，32%;部分,17%)。多发性神经病患者预后较差(卡方统计量:4.183;P = .041)。结论:同源PG是一种安全有效的治疗方法，可用于治疗对标准治疗无反应的DLEU。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Wounds : a compendium of clinical research and practice 医学-皮肤病学

CiteScore

1.50

自引率

11.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Wounds is the most widely read, peer-reviewed journal focusing on wound care and wound research. The information disseminated to our readers includes valuable research and commentaries on tissue repair and regeneration, biology and biochemistry of wound healing, and clinical management of various wound etiologies. Our multidisciplinary readership consists of dermatologists, general surgeons, plastic surgeons, vascular surgeons, internal medicine/family practitioners, podiatrists, gerontologists, researchers in industry or academia (PhDs), orthopedic surgeons, infectious disease physicians, nurse practitioners, and physician assistants. These practitioners must be well equipped to deal with a myriad of chronic wound conditions affecting their patients including vascular disease, diabetes, obesity, dermatological disorders, and more. Whether dealing with a traumatic wound, a surgical or non-skin wound, a burn injury, or a diabetic foot ulcer, wound care professionals turn to Wounds for the latest in research and practice in this ever-growing field of medicine.