A multicenter retrospective study comparing a polylactic acid CAMP with intact fish skin graft or a collagen dressing in the management of diabetic foot ulcers and venous leg ulcers.

IF 1.4 4区 医学 Q3 DERMATOLOGY Wounds : a compendium of clinical research and practice Pub Date : 2024-09-01
Brock A Liden, Tiffany Liu, Matthew Regulski, Melissa Foster, Ryan DeLeon, Gina Palazzi, Jose L Ramirez-GarciaLuna
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Abstract

Background: Venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs) are examples of chronic wounds that pose an ongoing health care challenge. Despite significant progress in managing such wounds, challenges persist that require innovative solutions. Cellular, acellular, and matrix-like products (CAMPs) are advanced therapies designed to facilitate chronic wound healing. Polylactic acid (PLA) is a synthetic material used in alloplastic CAMPs that has shown promise in the management of burns and traumatic injuries.

Objective: To retrospectively assess the effect of PLA in promoting chronic wound healing compared with 2 other well-established CAMPs.

Materials and methods: This retrospective chart review, which was conducted in 3 high-volume wound care clinics, aimed to compare the efficacy of 2 advanced wound care products vs a PLA alloplastic CAMP in promoting DFU and VLU closure. The study included 131 wounds treated with a non-CAMP collagen dressing, fish skin grafts (FSGs), or PLA matrices. Inclusion criteria included single Wagner grade 1 or 2 DFUs or Clinical-Etiology-Anatomy-Pathophysiology classification score C6 VLUs, present for at least 12 to 52 weeks, and measuring between 1 cm² and 20 cm². Patients received weekly treatments with 1 of 3 CAMPs, along with standard care. The primary outcome was time to achieve full healing, and the secondary outcome was the proportion of ulcers healed at 12 weeks.

Results: The PLA alloplastic CAMP demonstrated superior outcomes, with a 50% and 20% reduction in time to heal DFUs compared with collagen dressings and FSG, respectively (P < .001). For VLUs, PLA exhibited even more impressive results, achieving 95% and 40% reduction compared with collagen and FSG, respectively (P < .001). PLA allografts displayed a 55% higher rate of full healing by 12 weeks compared with collagen dressings, and a 26% higher rate compared with FSG (P < .001).

Conclusion: This study highlights the unique attributes of PLA for achieving wound closure. PLA-based alloplastic CAMPs are promising treatments, offering rapid healing, increased closure rates, and multifaceted benefits for wound healing.

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一项多中心回顾性研究,比较了聚乳酸 CAMP 与完整鱼皮移植或胶原蛋白敷料在治疗糖尿病足溃疡和腿部静脉溃疡中的效果。
背景:腿部静脉溃疡(VLU)和糖尿病足溃疡(DFU)是慢性伤口的典型代表,给医疗保健带来了持续的挑战。尽管在管理此类伤口方面取得了重大进展,但挑战依然存在,需要创新的解决方案。细胞、非细胞和类基质产品(CAMPs)是旨在促进慢性伤口愈合的先进疗法。聚乳酸(PLA)是一种用于异体CAMPs的合成材料,在治疗烧伤和外伤方面前景看好:回顾性评估聚乳酸与其他两种成熟的 CAMP 相比在促进慢性伤口愈合方面的效果:这项回顾性病历审查在 3 家高容量伤口护理诊所进行,旨在比较 2 种先进伤口护理产品与聚乳酸异体 CAMP 在促进 DFU 和 VLU 闭合方面的功效。研究共纳入了 131 例使用非 CAMP 胶原敷料、鱼皮移植 (FSG) 或聚乳酸基质治疗的伤口。纳入标准包括单个瓦格纳 1 级或 2 级 DFU 或临床-病因-解剖-病理生理学分类评分 C6 VLU,至少存在 12 到 52 周,面积在 1 平方厘米到 20 平方厘米之间。患者每周接受 3 种 CAMPs 中的 1 种治疗,同时接受标准护理。主要结果是达到完全愈合的时间,次要结果是12周时溃疡愈合的比例:与胶原敷料和 FSG 相比,聚乳酸异体 CAMP 的疗效更佳,DFU 的愈合时间分别缩短了 50%和 20%(P < .001)。对于 VLU,聚乳酸的效果更加显著,与胶原和 FSG 相比,分别缩短了 95% 和 40% 的时间(P < .001)。与胶原敷料相比,聚乳酸异体移植物在 12 周内的完全愈合率提高了 55%,与 FSG 相比提高了 26%(P < .001):本研究强调了聚乳酸在实现伤口闭合方面的独特属性。以聚乳酸为基础的异体 CAMPs 是一种很有前景的治疗方法,它能快速愈合,提高闭合率,对伤口愈合有多方面的好处。
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来源期刊
CiteScore
1.50
自引率
11.80%
发文量
77
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.
期刊最新文献
Wounds resulting from intradermal injection of sodium hypochlorite: a case report. Application of clinician support tools to improve wound healing outcomes and simplify treatment selection for effective exudate management. Bromelain-based enzymatic debridement: mechanism of action in the wound environment. A literature review. Collaboration encourages innovation: setting new standards in wound care with the Wound Care Collaborative Community expert panel consensus Recommendations. Effect of introduction of elastic compression bandages on quality of life in patients with lower extremity vascular skin ulcers: a prospective study correlating WOUND-Q patient-reported outcome measures and evidence-based medicine.
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