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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Sample of skin substitutes, indication for use, and study data[1]

Sample of skin substitutes, indication for use, and study data[1]
Matrix Source Indication Study outcome Level of evidence
BLCC

Dermal part: bovine type I collagen with human neonatal foreskin fibroblasts.

Epidermal part: keratinocytes. 		VLUs, DFUs, PG, burns, acute wounds, epidermolysis bullosa, post-radiation ulcers

In VLUs: 63% of patients were healed at 6 months compared with 49% (using standard of care). Also, higher likelihood to achieve complete wound closure by 6 months than the control group.

In DFUs: Closure in 56% of patients by 12 weeks compared with 39% of patients with conventional therapy. 		Level I[2,3]
DHACM DHACM is composed of a single layer of epithelial cells, a basement membrane, and an avascular connective tissue matrix. DFUs, VLUs, chronic vascular ulcers, partial- and full- thickness wounds, PUs, surgical wounds, trauma wounds, and burns

In DFUs: 97% of patients treated with DHACM achieved wound closure by 12 weeks compared with 51% with standard wound care.

In VLUs: 62% of patients treated with DHACM plus compression therapy showed wound closure at 4 weeks compared with only 32% with compression therapy alone. 		Level II[4,5]
DRM Composed of a cross-linked bovine collagen and glycosaminoglycan dermal layer, and a silicone epidermal layer. Partial- and full-thickness wounds, PUs, VLUs, DFUs, surgical wounds, burns, and draining wounds

The combination of DRM with postoperative negative-pressure therapy versus DRM alone increased the take rate from 78% to 98%.

The interval between DRM and skin transplantation was decreased from 24 to 10 days and can decrease length of hospital stay.

In DFUs: 51% of patients achieved complete closure with DRM compared with 32% of the control group. 43 days to closure versus 78 days. 		Level I and II[6,7]
CA  Cadaveric human skin that has been processed to remove the epidermis. Indicated in the repair of damaged or inadequate integument including surgical wounds from abdominal wall reconstruction and breast reconstruction 86% of patients receiving CA were closed by 16 weeks compared with only 29% of control patients (diabetic lower extremity wounds). Level II[8]
BLCC: bilayered living cell construct; VLU: venous leg ulcer; DFU: diabetic foot ulcer; PG: pyoderma gangrenosum; DHACM: dehydrated human amnion/chorion membrane; DRM: dermal replacement matrix; PU: pressure ulcer; RTM: Regenerative Tissue Matrix; CA: cadaveric allograft.
References:
  1. Shahrokhi S, Arno A, Jeschke MG. The use of dermal substitutes in burn surgery: Acute phase. Wound Repair Regen 2014; 22:14.
  2. Veves A, Falanga V, Armstrong DG, et al. Graftskin, a human skin equivalent, is effective in the management of noninfected neuropathic diabetic foot ulcers: A prospective randomized multicenter clinical trial. Diabetes Care 2001; 24:290.
  3. Kirsner RS, Sabolinski ML, Parsons NB, et al. Comparative effectiveness of a bioengineered living cellular construct vs. a dehydrated human amniotic membrane allograft for the treatment of diabetic foot ulcers in a real world setting. Wound Repair Regen 2015; 23:737.
  4. Serena TE, Carter MJ, Le LT, et al. A multicenter, randomized, controlled clinical trial evaluating the use of dehydrated human amnion/chorion membrane allografts and multilayer compression therapy vs. multilayer compression therapy alone in the treatment of venous leg ulcers. Wound Repair Regen 2014; 22:688.
  5. Zelen CM, Serena TE, Gould L, et al. Treatment of chronic diabetic lower extremity ulcers with advanced therapies: A prospective, randomised, controlled, multi-centre comparative study examining clinical efficacy and cost. Int Wound J 2016; 13:272.
  6. Driver VR, Lavery LA, Reyzelman AM, et al. A clinical trial of Integra Template for diabetic foot ulcer treatment. Wound Repair Regen 2015; 23:891.
  7. Jeschke MG, Rose C, Angele P, et al. Development of new reconstructive techniques: Use of Integra in combination with fibrin glue and negative-pressure therapy for reconstruction of acute and chronic wounds. Plast Reconstr Surg 2004; 113:525.
  8. 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.
Adapted from: Hughes OB, Rakosi A, Macquhae F, et al. A review of cellular and acellular matrix products: Indications, techniques, and outcomes. Plast Reconstr Surg 2016; 138:138S.
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