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 DOI:10.25270/wnds/23011

Sara Ferreira, Marco Sampaio, Margarida Oliveira, Francisco Dias, Eduarda Valente, Maria Luís Queirós, R. 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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使用同种血小板凝胶治疗难治性糖尿病下肢溃疡：一家三甲医院的额外经验。

背景白血病溃疡是发病的主要原因。适当的治疗是必不可少的，目前已经出现了实现溃疡愈合的新方法，包括应用 PG。目的本研究评估了标准治疗难治的慢性非感染性 DLEU 患者使用同种异体 PG 的有效性和安全性，以及患者合并症和治疗反应之间可能存在的相关性。材料与方法评估了2014年1月至2022年10月期间接受同种异体PG治疗的慢性难治性白LEU患者的数据（合并症、伤口特征、治疗次数和时间、结果）。结果分为完全应答（溃疡完全愈合并再上皮化）、部分应答（面积缩小≥50%和/或疼痛改善）或无应答。组间比较采用卡方检验，α水平设为小于 0.05。结果共有 81 名患者（63 名男性，18 名女性；年龄中位数，65 岁；HbA1c 中位数，7.6%；溃疡面积中位数，2.9 平方厘米）被建议应用 PG。共有 62 名患者患有 3 种或更多合并症。对 69 名患者的疗效进行了评估，结果显示 49% 的患者有反应（完全反应 32%；部分反应 17%）。多发性神经病患者的疗效较差（卡方统计：4.183；P = .041）。结论对于标准疗法无效的 DLEU，同源 PG 是一种安全且可能有效的替代疗法。

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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.