Use of a human acellular dermal wound matrix in patients with complex wounds and comorbidities.
Objective: Rising prevalence of obesity and uncontrolled diabetes mellitus has resulted in an increasing number of patients with multiple comorbidities who require treatment for chronic complex wounds. Because patients with diabetes and foot ulcers may have a higher risk for amputations, techniques...
| Publicado en: | Journal of Wound Care Vol. 24; no. 6; pp. 261 - 268 |
|---|---|
| Autores principales: | , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Mark Allen Holdings Limited
Jun2015
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109803043&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109803043 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09690700 H3U jtl: Journal of Wound Care issn: 09690700 maglogo: N pubinfo: dt: Jun2015 vid: 24 iid: 6 pid: 11383 pub: Mark Allen Holdings Limited artinfo: ui: 109803043 103293539 10.12968/jowc.2015.24.6.261 NLM26075374 109803043 ppf: 261 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Use of a human acellular dermal wound matrix in patients with complex wounds and comorbidities. aug: au: Williams, M.L. Holewinski, J.E. affil: Chairman, Division of Podiatry, Aventura Hospital and Medical Center, Aventura, FL; Adjunct Professor, School of Podiatry, Barry University, Aventura, FL sug: subj: Wound Healing Comorbidity Allografts Soft Tissue Injuries Diabetic Foot Ulcer Amputation Risk Assessment Antibiotics Human Male Female Adult Middle Age Aged Aged, 80 and Over Descriptive Statistics Data Analysis Software Regeneration Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Objective: Rising prevalence of obesity and uncontrolled diabetes mellitus has resulted in an increasing number of patients with multiple comorbidities who require treatment for chronic complex wounds. Because patients with diabetes and foot ulcers may have a higher risk for amputations, techniques that facilitate complex wound healing and prevent limb amputation are desirable. Here, we investigate a limb preservation strategy that includes application of a human acellular dermal wound matrix (HADWM). l Method: Medical history, physical examination and full wound assessment were completed for all patients. Systemic antibiotics and appropriate offloading were prescribed as needed. Wounds were debrided to create a bleeding bone and/or wound base for HADWM (Graftjacket regenerative tissue matrix, Wright Medical Technology, Inc., licensed by KCI, an Acelity company, San Antonio, TX). Healing progress was monitored over four weeks with weekly postoperative visits. ‘Healed' was defined as full epithelialisation without drainage. l Results: Lower extremity ulcers, 16 in 13 patients, were treated with HADWM between May 2004 and July 2013. The median patient age was 76 years (range: 38-90). The average number of comorbidities was three per patient, while 6 (46%) patients had ≥4 comorbidities. Diabetes mellitus (92%) and peripheral vascular disease (77%) were the two most common. All 16 (100%) wounds healed without complications. There were no recurrences in the 11 wounds of the nine patients available for follow-up. Of these patients two had previously advised to receive major leg amputations retained functional limbs. l Conclusion: The results in this small study reflect our practice’s 10-year experience using HADWM as part of a limb preservation strategy. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|