■NovoSorb(Poly-NovoLtd,澳大利亚)可生物降解的临时基质(BTM)是一种新型的人工真皮基质。以前的文献侧重于其在烧伤重建中的使用;然而,本文介绍了其在多种伤口病因中的应用。作者介绍了迄今为止最大,最多样化的案例之一,并旨在提供独立的临床实践基准。
■进行了一项回顾性观察性研究。患者人口统计学和临床数据(伤口病因,site,总体表面积(TBSA),伤口床,清创术的数量,BTM集成的时间,收集植皮时间)并进行亚组分析。
■该队列由37名患者组成(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)。成功的BTM集成,允许随后的分层厚度皮肤移植(STSG),发生在70%的病例中,尽管总体并发症率为51%。从BTM应用到STSG的平均时间为53天。在六周BTM施用期之前或之后进行移植时,STSG结果没有差异。当各种伤口床(筋膜,肌腱,骨膜)进行比较。年龄>65岁的患者更容易出现并发症;然而,这并不影响整合的速度。糖尿病和吸烟与整体整合的关系无统计学意义。
■特别是在合并症患者中,BTM应用和STSG之间的时间可能比制造商的建议长。此外,数据表明,在难以愈合/恶性伤口中,伤口床优化程度更高,间隔监测更密切,以及老年患者和合并症患者。然而,BTM看起来很健壮(即使在感染中也是如此),并且有望成为有用的重建工具。
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.