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Application of a paste-type acellular dermal matrix for coverage of chronic ulcerative wounds

  • Jeon, Minseok (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University School of Medicine) ;
  • Kim, So Young (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University School of Medicine)
  • 투고 : 2018.05.31
  • 심사 : 2018.10.02
  • 발행 : 2018.11.15

초록

Background Chronic wounds occur due to failure of the normal healing process, associated with a lack of deposition of cellular components and a suitable microenvironment such as the extracellular matrix (ECM). Acellular dermal matrix (ADM) is viewed as an ECM substitute, and a paste-type ADM has recently been introduced. We hypothesized that CGPaste, an injectable paste-type ADM, could serve as a scaffold and promote wound healing. Methods We retrospectively studied seven patients in whom CGPaste was applied between 2017 and 2018, who had pressure ulcers, necrotizing fasciitis, diabetic foot ulcers, traumatic defects, and osteomyelitis. The goal of applying CGPaste was to achieve complete wound healing with re-epithelialization or growth of granulation tissue, depending upon the wound bed status. CGPaste was injected based on the wound size along with the application of a dressing. Results Four of the seven patients showed granulation tissue on their wound bed, while the other three patients had a bony wound bed. The mean wound area was $453.57mm^2$ and the depth was 10.71 mm. Wound healing occurred in five of the seven patients (71.43%). The mean duration of complete healing was 2.4 weeks. Two patients showed failure due to paste absorption (29.57%); these patients had wound beds comprising bone with relatively large and deep wounds ($40{\times}30$ and $30{\times}20mm^2$ in area and 15 and 10 mm in depth). Conclusions CGPaste is an effective option for coverage of small and deep chronic wounds for which a flap operation or skin grafting is unfeasible.

키워드

참고문헌

  1. Braddock M. Tissue repair and ulcer/wound healing-Institut Pasteur Euroconference: molecular mechanisms, therapeutic targets and future directions. IDrugs 2005;8:381-3.
  2. Kirsner RS, Bohn G, Driver VR, et al. Human acellular dermal wound matrix: evidence and experience. Int Wound J 2015;12:646-54. https://doi.org/10.1111/iwj.12185
  3. Cazzell S, Vayser D, Pham H, et al. A randomized clinical trial of a human acellular dermal matrix demonstrated superior healing rates for chronic diabetic foot ulcers over conventional care and an active acellular dermal matrix comparator. Wound Repair Regen 2017;25:483-97. https://doi.org/10.1111/wrr.12551
  4. Martin BR, Sangalang M, Wu S, et al. Outcomes of allogenic acellular matrix therapy in treatment of diabetic foot wounds:an initial experience. Int Wound J 2005;2:161-5. https://doi.org/10.1111/j.1742-4801.2005.00099.x
  5. Jang HJ, Kim YM, Yoo BY, et al. Wound-healing effects of human dermal components with gelatin dressing. J Biomater Appl 2018;32:716-24. https://doi.org/10.1177/0885328217741758
  6. Green T, Kavros S, Springer S, et al. Team approach: complex dermal wound-healing utilizing negative-pressure wound therapy (NPWT) in orthopaedic trauma. JBJS Rev 2018;6:e1.
  7. Jeffery S, Leaper D, Armstrong D, et al. Using negative pressure wound therapy to prevent surgical site infection. J Wound Care 2018;27(Suppl 3):S5-13. https://doi.org/10.12968/jowc.2018.27.Sup3.S5
  8. Choi JY, Kim SH, Oh GJ, et al. Management of defects on lower extremities with the use of matriderm and skin graft. Arch Plast Surg 2014;41:337-43. https://doi.org/10.5999/aps.2014.41.4.337
  9. Brigido SA. The use of an acellular dermal regenerative tissue matrix in the treatment of lower extremity wounds: a prospective 16-week pilot study. Int Wound J 2006;3:181-7. https://doi.org/10.1111/j.1742-481X.2006.00209.x

피인용 문헌

  1. Application of a paste-type acellular dermal matrix for coverage of chronic ulcerative wounds vol.46, pp.3, 2018, https://doi.org/10.5999/aps.2019.00066
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  3. Socioeconomic effects of pressure ulcer vol.64, pp.1, 2021, https://doi.org/10.5124/jkma.2021.64.1.11
  4. Application of paste-type acellular dermal matrix in hard-to-heal wounds vol.30, pp.5, 2018, https://doi.org/10.12968/jowc.2021.30.5.414
  5. Successful Treatment of a Large Coccygeal Pressure Ulcer Using Injectable Acellular Dermal Matrix: A Case Report vol.17, pp.3, 2021, https://doi.org/10.22467/jwmr.2021.01683
  6. Smart wound dressings for wound healing vol.41, pp.None, 2018, https://doi.org/10.1016/j.nantod.2021.101290