Eric L. Johnson MD , Georgina M. Michael MSN, RNFA, FNP-BC , Yeabsera G. Tamire BS
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Secondary endpoints included 4-week percent reduction in sinus tract probing depth and peri-tract wound surface area, days and number of grafts to resolution, number of wound-related infections, and 1-year recurrence rate for closed sinus tracts. All vCPM patients demonstrated complete sinus tract resolution compared to zero closures in the dHACM group (p = 0.00216). The vCPM group achieved greater percent reduction in probing depth (73.3 ± 21.9 versus −4.4 ± 91.3) and surrounding wound surface area (34.8 ± 86.8 versus −279.3 ± 454.9) at 4 weeks than dHACM. The use of viable intact cryopreserved placental membrane has demonstrated positive clinical outcomes for the treatment for refractory exudative sinus tracts and may be an alternative to repeat surgical intervention.</p></div>","PeriodicalId":90358,"journal":{"name":"The journal of the American College of Clinical Wound Specialists","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jccw.2017.09.001","citationCount":"5","resultStr":"{\"title\":\"Placental Membranes for Management of Refractory Cutaneous Sinus Tracts of Surgical Origin: A Pilot Study\",\"authors\":\"Eric L. Johnson MD , Georgina M. Michael MSN, RNFA, FNP-BC , Yeabsera G. Tamire BS\",\"doi\":\"10.1016/j.jccw.2017.09.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Despite advances in surgical technique, postoperative complications may lead to refractory cutaneous sinus tracts or tunnels. Negative pressure wound therapy is difficult to apply in longer tracts with a narrow diameter opening and conservative treatment failures ultimately necessitate surgical revisions. The aim of this pilot study was a clinical utility assessment of two different commercial placental membrane products for refractory cutaneous sinus tracts of surgical origin. Patients were treated with viable cryopreserved placental membrane (vCPM, n = 6) or devitalized dehydrated amnion/chorion membrane (dHACM, n = 6). The primary outcome measurement was the proportion of complete sinus tract depth resolution without exudate. Secondary endpoints included 4-week percent reduction in sinus tract probing depth and peri-tract wound surface area, days and number of grafts to resolution, number of wound-related infections, and 1-year recurrence rate for closed sinus tracts. All vCPM patients demonstrated complete sinus tract resolution compared to zero closures in the dHACM group (p = 0.00216). The vCPM group achieved greater percent reduction in probing depth (73.3 ± 21.9 versus −4.4 ± 91.3) and surrounding wound surface area (34.8 ± 86.8 versus −279.3 ± 454.9) at 4 weeks than dHACM. 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引用次数: 5
摘要
尽管手术技术的进步,术后并发症可能导致难治性皮肤窦束或隧道。负压伤口治疗难以应用于较长的束和狭窄的直径开口,保守治疗失败最终需要手术翻修。本初步研究的目的是评估两种不同的商业胎盘膜产品用于手术源性难治性皮肤窦道的临床效用。患者分别接受活的低温保存胎盘膜(vCPM, n = 6)或失活的脱水羊膜/绒毛膜(dHACM, n = 6)治疗。主要观察指标为无渗出物的窦道深度完全溶解比例。次要终点包括4周窦道探探深度和窦道周围创面面积减少的百分比,移植物愈合的天数和数量,伤口相关感染的数量,以及封闭窦道1年的复发率。与dHACM组相比,所有vCPM患者均表现出完全的窦道溶解(p = 0.00216)。与dHACM相比,vCPM组在4周时探测深度(73.3±21.9比- 4.4±91.3)和周围创面面积(34.8±86.8比- 279.3±454.9)减少了更大的百分比。使用可存活的完整低温保存胎盘膜治疗难治性窦性渗出性瘘管已显示出积极的临床效果,可能是重复手术干预的替代方法。
Placental Membranes for Management of Refractory Cutaneous Sinus Tracts of Surgical Origin: A Pilot Study
Despite advances in surgical technique, postoperative complications may lead to refractory cutaneous sinus tracts or tunnels. Negative pressure wound therapy is difficult to apply in longer tracts with a narrow diameter opening and conservative treatment failures ultimately necessitate surgical revisions. The aim of this pilot study was a clinical utility assessment of two different commercial placental membrane products for refractory cutaneous sinus tracts of surgical origin. Patients were treated with viable cryopreserved placental membrane (vCPM, n = 6) or devitalized dehydrated amnion/chorion membrane (dHACM, n = 6). The primary outcome measurement was the proportion of complete sinus tract depth resolution without exudate. Secondary endpoints included 4-week percent reduction in sinus tract probing depth and peri-tract wound surface area, days and number of grafts to resolution, number of wound-related infections, and 1-year recurrence rate for closed sinus tracts. All vCPM patients demonstrated complete sinus tract resolution compared to zero closures in the dHACM group (p = 0.00216). The vCPM group achieved greater percent reduction in probing depth (73.3 ± 21.9 versus −4.4 ± 91.3) and surrounding wound surface area (34.8 ± 86.8 versus −279.3 ± 454.9) at 4 weeks than dHACM. The use of viable intact cryopreserved placental membrane has demonstrated positive clinical outcomes for the treatment for refractory exudative sinus tracts and may be an alternative to repeat surgical intervention.