PDF(Pubmed)
Abstract：
Pressure ulcers are caused by sustained pressure, friction, or shear on the skin which limits blood flow to the dermis and surrounding tissue. Symptoms include redness and ulceration and may result in a chronic wound. This ailment affects three million adults in the United States, and is a major burden to the healthcare system. Pressure ulcers are associated with pain and immobility that substantially lower the patient\'s quality of life, resulting in longer and more frequent hospitalization and a higher risk of mortality. As the severity of the pressure ulcer increases, it becomes more challenging for clinicians to successfully treat the wound and achieve healing objectives. Treatment of a pressure ulcer is more challenging when the wound is associated with infection, heavy exudate, inflammation, high enzymatic activity, and exposed bone and/or muscle. An advanced technology that may provide a new solution for the treatment of pressure ulcers is the use of a biodegradable synthetic hybrid-scale fiber matrix. The synthetic hybrid-scale fiber matrix provides a porous scaffold for cellular infiltration and vascularization that leads to granulation tissue formation and re-epithelialization, before completely resorbing via hydrolysis. In this case report, a patient who had a large sacral pressure ulcer present for over 16 years with two exposed spinal segments and exposed peritoneum was treated with the hybrid-scale fiber matrix. A total of nine applications of the material were applied over 11 weeks. The wound demonstrated significant healing, wound exudate was notably reduced, and no complications were observed. New epithelial tissue formation, tissue coverage over the exposed bone, infection management, and wound exudate reduction were observed to the extent that the patient was discharged from the hospital. Overall, the excellent healing response achieved on this 16-year-old chronic wound suggests that the synthetic hybrid-scale fiber matrix may be a good treatment option for difficult-to-heal pressure ulcers.
摘要：
压疮是由持续的压力引起的，摩擦,或剪切皮肤，限制血液流向真皮和周围组织。症状包括发红和溃疡，并可能导致慢性伤口。这种疾病影响了美国300万成年人，是医疗系统的主要负担。压疮与疼痛和不动有关，大大降低了患者的生活质量，导致住院时间更长，住院频率更高，死亡风险更高。随着压疮严重程度的增加，对于临床医生来说，成功治疗伤口并实现愈合目标变得更具挑战性。当伤口与感染有关时，治疗压疮更具挑战性，大量的渗出物，炎症,高酶活性，和暴露的骨骼和/或肌肉。可以为治疗压力性溃疡提供新解决方案的先进技术是使用可生物降解的合成混合尺度纤维基质。合成的杂化尺度纤维基质为细胞浸润和血管化提供了多孔支架，导致肉芽组织形成和再上皮化，在通过水解完全再吸收之前。在这个案例报告中,1例骶骨压迫性溃疡超过16年,有2个暴露的脊柱节段和暴露的腹膜,患者接受混合鳞纤维基质治疗.在11周内总共施用了9次材料。伤口显示出明显的愈合，伤口渗出物明显减少，无并发症发生。新的上皮组织形成，裸露骨头上的组织覆盖，感染管理,观察到伤口渗出物减少到患者出院的程度。总的来说,在这个16岁的慢性伤口上获得了优异的愈合反应,这表明合成的混合鳞片纤维基质可能是难以治愈的压力性溃疡的良好治疗选择.
