研究动态
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新固吸生物可降解暂时矩阵在创伤管理中的应用:文献综述与个案系列。

The use of NovoSorb biodegradable temporising matrix in wound management: a literature review and case series.

发表日期:2023 Aug 02
作者: Thomas Kidd, Valdone Kolaityte, Kuljyot Bajaj, David Wallace, David Izadi, Janak Bechar
来源: Burns & Trauma

摘要:

NovoSorb(Poly-Novo Ltd,澳大利亚)可降解临时基质(BTM)是一种新型人工真皮基质。之前的文献主要研究了它在烧伤重建中的应用,然而,本文描述了它在一系列创伤病因中的应用。作者提供了至今为止规模最大、最多样化的病例系列,并旨在提供一个独立的临床实践基准。我们进行了一项回顾性观察性研究。收集了患者的人口统计学和临床数据(创伤病因、部位、全身面积(TBSA)、创面、去皮次数、BTM融合时间、皮瓣移植时间),并进行亚组分析。整个队列共有37名患者(急性创伤伤口,n=19;难以愈合的伤口,n=9;急性感染,n=6;癌症,n=3)。在整体并发症发生率达51%的情况下,成功的BTM融合达到了70%,从而为随后的浅层剥离厚度皮瓣移植提供了可能。BTM涂抹到STSG的平均时间为53天。在BTM涂抹期间的六周之前或之后进行移植时,STSG结果没有差异。在比较不同创面(筋膜、肌腱、骨膜)时也没有差异。在65岁以上的患者中,出现并发症的可能性更大;然而,这并不影响融合的速度。糖尿病和吸烟与整体融合的关系没有统计学上的显著性。特别是在存在共病的患者中,BTM涂抹和STSG之间的时间可能会超过制造商的建议。此外,数据表明应更好地优化创面,密切监测难以愈合/恶性伤口、年长患者和合并症患者。然而,BTM表现出良好的性能(甚至在感染中),并显示出作为一种有用的重建工具的潜力。
NovoSorb (Poly-Novo Ltd, Australia) biodegradable temporising matrix (BTM) is a novel artificial dermal matrix. Previous literature is weighted towards its use in burns reconstruction; however, this paper describes its use within a range of wound aetiologies. The authors present one of the largest and most diverse case series to date, and aim to provide an independent benchmark of clinical practice.A retrospective observational study was performed. Patient demographics and clinical data (wound aetiology, site, total body surface area (TBSA), wound bed, number of debridements, time to BTM integration, time to skin grafting) were collected and subgroup analysis preformed.The cohort consisted of 37 patients (acute trauma wounds, n=19; hard-to-heal wounds, n=9; acute infections, n=6; cancer, n=3). Successful BTM integration, allowing subsequent split-thickness skin grafting (STSG), occurred in 70% of cases, despite an overall complication rate of 51%. Mean time from BTM application to STSG was 53 days. There was no difference in STSG outcomes when grafting was performed either before or after the six-week BTM application period. There was no difference when various wound beds (fascia, tendon, periosteum) were compared. Patients >65 years of age were more likely to experience complications; however, this did not affect the speed of integration. The relation of diabetes and smoking to overall integration had no statistical significance.In comorbid patients in particular, the time between BTM application and STSG may be longer than the manufacturer's recommendation. Furthermore, data suggest greater wound bed optimisation and closer interval monitoring in hard-to-heal/malignant wounds, and in older patients and patients with comorbidities. However, BTM appears robust (even in infection) and is showing promise as a useful reconstructive tool.