难以愈合的伤口可能不利于患者的生活质量。目前,缺乏主要的手术治疗方法,使用组织清创术的原理,临时伤口覆盖,以及随后的组织重建。这里,提出了一种新的方法,利用自体外周血的再生能力,通过称为缺氧调节的体外预处理过程。通过6例手术伤口证明了该方法的有效性,包括两例由于重度吸烟者的腹部成形术和臀部抬起手术后皮肤坏死而形成的大的全厚度真皮伤口,以及乳房手术后发生的广泛炎症组织损伤。虽然这些伤口大小不同(4-160cm2),几何和位置,所有这些都可以通过局部应用来自患者自身外周血的富含生长因子的缺氧预适应血清进行保守治疗。该治疗导致最近135天的伤口完全闭合。发现即使在大(>10cm2)的情况下,皮肤也会完全再生,全层伤口,最初在伤口床上没有真皮组织,强烈表明治疗针对关键的细胞再生机制,包括差异化,血管生成,肉芽组织诱导,收缩和上皮化。该方法易于临床应用,成本有效,并克服了经典重建方法的局限性。
Hard-to-heal wounds can be detrimental to patients\' quality of life. Currently, there is scarcity of therapeutic alternatives to mainstay surgical treatment, which uses the principles of tissue debridement, temporary wound coverage, and subsequent tissue reconstruction. Here, a new approach is proposed that harnesses the regenerative power of autologous peripheral blood, through a process termed hypoxia-adjusted in vitro preconditioning. The effectiveness of this method is demonstrated with six cases of surgical wounds, including two cases of large full-thickness dermal wounds that developed as a result of skin necrosis following abdominoplasty and buttock-lift procedures in heavy smokers, as well as a
case of extensive inflammatory tissue damage that occurred following breast surgery. While these wounds differed in size (4-160 cm2), geometry and location, all of them could be managed conservatively with topical application of growth factor-enriched hypoxia preconditioned serum derived from the patient\'s own peripheral blood. This treatment led to complete wound closure by latest 135 days. The finding of complete skin regeneration even in large (>10 cm2), full-thickness wounds, where initially no dermal tissue was available in the wound bed, strongly suggests that the treatment targeted key cellular regenerative mechanisms, including differentiation, angiogenesis, granulation tissue induction, contraction and epithelialization. The method is readily clinically applicable, cost effective, and overcomes limitations of the classic reconstructive approach.