Effectiveness of the combined therapy in the treatment of chronic non-healing wounds in patients with autoimmune diseases

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery Pub Date : 2025-02-01 DOI:10.1016/j.bjps.2024.11.033

Fatih Ceran , Mehmet Bozkurt , Percin Karakol

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引用次数: 0

Abstract

Objective

Autoimmune diseases are systemic conditions that can have negative effects on wound healing. The objective of the present study was to investigate the efficacy of combining bone marrow-derived mesenchymal stem cells (BM-MSCs), acellular dermal matrix (ADM), split-thickness skin graft (STSG), and negative-pressure wound therapy (NPWT) for treating patients with autoimmune diseases and chronic non-healing wounds.

Methods

Thirty-four patients with autoimmune diseases and non-healing chronic wounds of the lower extremities between 2012 and 2023 were included in the study. Among these, 18 patients had Behçet’s disease, 8 patients had polyarteritis nodosa, and 8 patients had systemic lupus erythematosus. All patients underwent split-thickness skin grafting in external centers. The wounds were debrided, and BM-MSCs concentrate was injected into the wound base. A suitable ADM was applied to the wound. STSG were adapted onto the ADM. The grafts were closed with NPWT.

Results

Patients were followed-up for an average of 1.2 years. No necrosis was observed at the wound sites of the post-operative patients. During long-term follow-up, no wounds were observed at the same sites.

Conclusion

Although autoimmune diseases fall within the scope of rheumatology, the treatment of chronic non-healing wounds that accompany such diseases requires a multidisciplinary approach. We demonstrated that the combined use of BM-MSCs, ADM, STSG, and NPWT presents an effective approach in the healing of these types of wounds.

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联合治疗自身免疫性疾病患者慢性不愈合伤口的疗效观察

目的：自身免疫性疾病是一种对伤口愈合有负面影响的全身性疾病。本研究的目的是探讨骨髓间充质干细胞（BM-MSCs）、脱细胞真皮基质（ADM）、裂厚皮肤移植（STSG）和负压伤口治疗（NPWT）联合治疗自身免疫性疾病和慢性不愈合伤口患者的疗效。方法：选取2012 - 2023年间34例自身免疫性疾病伴下肢慢性伤口未愈合患者作为研究对象。其中behaperet病18例，结节性多动脉炎8例，系统性红斑狼疮8例。所有患者均行外中心裂皮植皮术。创面清创，将BM-MSCs浓缩液注入创底。将合适的ADM涂抹在伤口上。将STSG移植到adm上，用NPWT封闭移植物。结果：患者平均随访1.2年。术后创面未见坏死。在长期随访中，在相同部位未观察到伤口。结论：虽然自身免疫性疾病属于风湿病学的范畴，但伴随这些疾病的慢性不愈合伤口的治疗需要多学科的方法。我们证明联合使用BM-MSCs、ADM、STSG和NPWT是一种有效的治疗这些类型伤口的方法。

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

Journal of Plastic Reconstructive and Aesthetic Surgery 医学-外科

CiteScore

3.10

自引率

11.10%

发文量

578

审稿时长

3.5 months

期刊介绍： JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.