Use of three-dimensional acellular collagen matrix in deep or tunnelling diabetic foot ulcers: a retrospective case series.

IF 1.5 4区 医学 Q3 DERMATOLOGY Journal of wound care Pub Date : 2024-09-01 DOI:10.12968/jowc.2024.0176
Raymond J Abdo, Amy L Couch
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Abstract

Objective: While most xenograft wound matrices are flat sheets not designed for deep or tunnelling wounds, three-dimensional acellular collagen matrices (3D-ACM) can fill deep wound beds and enable full wound wall apposition. This case series examines the use of 3D-ACM in treating diabetic foot ulcers (DFUs) that are deep, tunnelling, undermining, or irregularly shaped. We report outcomes of cases where 3D-ACM was applied to deep or tunnelling DFUs present for at least four weeks.

Method: In this retrospective case series, 3D-ACM was applied, healing was monitored and measurements were collected. Additional 3D-ACM was applied as needed.

Results: In total, 11 patients with 13 wounds were treated. Improved wound appearance and reduced size were observed at most follow-ups. Mean initial wound depth was 1.6cm, and several wounds showed significant depth reductions shortly after therapy initiation. In total, 62% of wounds (8/13) reached 50% closure by four weeks. Additionally, 54% (7/13) were fully closed by 12 weeks. The remaining 46% (6/13) took between 12-22.3 weeks to heal. Overall mean therapy time was 13.1 weeks (range: 2.0-22.3 weeks). Deeper wounds generally took longer to close.

Conclusion: The findings of this case series showed that 3D-ACM could offer a protective microenvironment for wound management for deep or tunnelling DFUs. While some took >12 weeks to close, this may be attributable to large initial depths and volumes, rather than a failure to respond to the treatment modality. Other wounds that require a conforming 3D matrix, enabling full wound wall apposition, may benefit from 3D-ACM. Further investigations would be beneficial to understand the capabilities of this treatment modality.

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在深层或隧道型糖尿病足溃疡中使用三维无细胞胶原基质:回顾性病例系列。
目的:大多数异种伤口基质都是扁平片状,不适合深层或隧道伤口,而三维无细胞胶原基质(3D-ACM)可以填充深层伤口床,使伤口壁完全贴合。本系列病例探讨了三维无细胞胶原基质在治疗深层、隧道式、破坏性或不规则形状的糖尿病足溃疡(DFU)中的应用。我们报告了对至少存在四周的深层或隧道型 DFU 应用 3D-ACM 的病例结果:在这一回顾性病例系列中,我们应用了 3D-ACM 技术,并对愈合情况进行了监测和测量。结果:共对 11 名患者的 13 处伤口进行了 3D-ACM 治疗:结果:共有 11 名患者的 13 处伤口接受了治疗。结果:共有 11 名患者的 13 处伤口接受了治疗,大多数随访结果显示伤口外观有所改善,伤口面积缩小。最初伤口的平均深度为 1.6 厘米,有几处伤口在治疗开始后不久就出现了明显的深度减小。总共有 62% 的伤口(8/13)在四周内达到了 50% 的闭合。此外,54%的伤口(7/13 例)在 12 周前完全闭合。其余 46% 的伤口(6/13)需要 12-22.3 周才能愈合。总体平均治疗时间为 13.1 周(范围:2.0-22.3 周)。较深的伤口一般需要更长时间才能愈合:本系列病例的研究结果表明,3D-ACM 可为深部或隧道型 DFU 的伤口管理提供保护性微环境。虽然有些伤口需要 12 周以上的时间才能愈合,但这可能是由于最初的伤口深度和体积较大,而不是对治疗方式没有反应。其他需要符合要求的三维基质,使伤口壁完全贴合的伤口也可能受益于三维-ACM。进一步的研究将有助于了解这种治疗方式的能力。
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来源期刊
Journal of wound care
Journal of wound care DERMATOLOGY-
CiteScore
2.90
自引率
10.50%
发文量
215
期刊介绍: Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.
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