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Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices.  

2014-01-15 13:57:56|  分类: 骨科技术 |  标签: |举报 |字号 订阅

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上下肢 创面愈合  : 一个使用脱细胞的皮肤真皮基质的系统评价。
作者: Iorio MLShuck JAttinger CE
出处: Plast Reconstr Surg.2012V130N5 Suppl 2 :232S-41S   [IF:3.535]
相关链接: Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices. - 飞翔的泪 - 小骨头的博客Google 引文  Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices. - 飞翔的泪 - 小骨头的博客PubMed相关文献  
通道揭示: Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices. - 飞翔的泪 - 小骨头的博客DOI  Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices. - 飞翔的泪 - 小骨头的博客PubMed 全文链接及在线提交请求信息  Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices. - 飞翔的泪 - 小骨头的博客Google全文通道
证据强度: Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices. - 飞翔的泪 - 小骨头的博客Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices. - 飞翔的泪 - 小骨头的博客Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices. - 飞翔的泪 - 小骨头的博客Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices. - 飞翔的泪 - 小骨头的博客Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices. - 飞翔的泪 - 小骨头的博客Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices. - 飞翔的泪 - 小骨头的博客Wound healing in the upper and lower extremities: a systematic review on the use of acellular dermal matrices. - 飞翔的泪 - 小骨头的博客

摘要:
BACKGROUND: Use of biologically engineered acellular dermal matrices in the upper and lower extremities is increasingly recognized as a means of achieving definitive healing in the setting of both acute and chronic injuries but data and evidence supporting their use are limited. The authors performed this systematic review to identify all available evidence for the use of matrices in nonburn extremity reconstruction. METHODS: A systematic review of the Cochrane and MEDLINE databases was performed to identify all reports of the application of matrices in wounds of the upper and lower extremities. Reports that included fewer than five patients and that involved cellular seeding, nonhuman studies, and burn injuries were excluded. Studies were evaluated for quality of statistical measures and outcomes, and a level of evidence was assigned in accordance with the American Society of Plastic Surgeons' Rating Levels of Evidence. RESULTS: Of an initial 2422 reports, 13 primary reports were identified (10 case series and three randomized controlled trials) representing a total of 432 patients and 441 discrete wounds. After evidence review, 10 of these studies represented level IV evidence, two studies represented level II evidence, and one study achieved level I evidence. CONCLUSIONS: Extremity wound management continues to rely on adequate vascular supply, debridement with eradication of infection, off-loading, and/or immobilization. Current data, although limited, appear to support the use of acellular dermal matrices in chronic and acute injuries where there is exposed bone, tendon, and/or muscle. They may provide a simple technique to achieve timely and durable tissue coverage in extremity wounds.
背景: 利用生物工程脱细胞真皮矩阵在上部和下肢越来越多地被视为实现彻底愈合的急性和慢性伤害设置中的一种手段但数据和证据支持他们的用途有限。作者进行本系统的审查,以确定使用矩阵 nonburn 下肢重建中的所有现有的证据。方法: 系统 Cochrane 和 MEDLINE 数据库的被进行审查,以确定矩阵在上限和下限四肢创伤中的应用程序的所有报告。报告,包含少于五个病人,这涉及细胞播种、 非人研究和烧伤被排除了。研究了评估的统计措施和成果,质量和水平的证据根据证据美国社会的整形外科医生的评分级别的指派。结果: 初始 2422年报告,13 个主报告确定了 (10 箱系列和三项随机对照的试验) 代表共有 432 病人和 441 离散伤口。证据审查,这些研究的 10 表示四级证据后,两个研究代表级二证据,和一个研究达到的水平,我的证据。结论: 下肢伤口管理继续依赖于足够的血管供应,消除感染、 卸货,和/或固定化清除病灶。当前的数据,虽然有限,但似乎支持脱细胞真皮矩阵的使用在慢性和急性损伤那里有骨外露、 肌腱,和/或肌肉。他们可能会提供简单的技术实现及时和持久组织覆盖在肢体的伤口。(电脑自助翻译结果)

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