Impact of Synthetic Extracellular Matrices in Combination Therapy with Amniotic Allografting in the Treatment of Diabetic Foot Wounds: A Case Series.

IF 0.8 Q4 SURGERY Surgical technology international Pub Date : 2024-07-15 DOI:10.52198/24.STI.44.WH1770
Arthur Evensen, Jodi Walters, James Dancho, Valarie Samoy, David Jolley
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Abstract

Synthetic extracellular matrices are artificial polymers that are elongated and deposited as a matrix of nanofibers which mimic the native extracellular matrix. RenovoDerm® Anthem™ Wound Matrix (Columbus, Ohio) is comprised of polyglycolic acid and poly (L-lactide-co-caprolactone) which degrade by hydrolysis into a-hydroxy and fatty acids, lowering the pH and promoting regenerative cellular activity including angiogenesis. Amniotic allografts contain growth factors, cytokines, amino acids, extracellular matrix proteins, and hyaluronic acid which are recognized as intrinsic to the wound healing process. Synthetic extracellular matrices alone or in combination with amnio allografts do not have large bodies of evidence which demonstrate their effectiveness in the treatment of wounds. Presently, no prior studies have been performed to assess what impact these therapies may have on wound healing when used concurrently. The aim of this investigation was to assess whether a synergistic effect is produced with combination therapy using synthetic extracellular matrix and amniotic allografting. In this article, we present four cases of diabetic foot ulcerations treated with combination therapy. An amniotic fluid allograft, and/or membrane amniotic allograft, was implanted with a synthetic extracellular matrix dressing over top of the graft(s) at weekly intervals. All wounds demonstrated a greater than 80% decrease in wound size within four applications and achieved more than 95% wound closure after six applications.

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合成细胞外基质与羊膜异体移植联合疗法在治疗糖尿病足伤口中的影响:病例系列。
人工合成细胞外基质是一种人工聚合物,它被拉长并沉积为纳米纤维基质,可模仿原生细胞外基质。RenovoDerm® Anthem™ Wound Matrix(俄亥俄州哥伦布市)由聚乙醇酸和聚(L-乳酸-共己内酯)组成,可通过水解降解为 a- 羟基和脂肪酸,降低 pH 值,促进包括血管生成在内的细胞再生活动。羊膜异体移植物含有生长因子、细胞因子、氨基酸、细胞外基质蛋白和透明质酸,这些被认为是伤口愈合过程中的内在因素。合成细胞外基质单独使用或与羊膜异体移植物结合使用时,并没有大量证据证明其在治疗伤口方面的有效性。目前,还没有研究评估这些疗法同时使用会对伤口愈合产生什么影响。本研究旨在评估使用合成细胞外基质和羊膜异体移植的联合疗法是否会产生协同效应。本文介绍了四例采用联合疗法治疗糖尿病足溃疡的病例。羊水同种异体移植和/或羊膜同种异体移植与合成细胞外基质敷料一起植入,每周一次。使用四次后,所有伤口的面积都缩小了 80% 以上,使用六次后,伤口闭合率达到 95% 以上。
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141
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