To compare the therapeutic efficacy of cryopreserved amniotic membrane (AM) grafts and standard of care (SOC) in treating nonhealing wounds (NHW) through a prospective multicenter clinical trial, 42 patients (76% polymorbid) with 54 nonhealing wounds of various etiologies (mainly venous) and an average baseline size of 20 cm2 were included. All patients were treated for at least 6 weeks in the center before they were involved in the study. In the SOC group, 29 patients (36 wounds) were treated. If the wound healed less than 20% of the baseline size after 6 weeks, the patient was transferred to the AM group (35 patients, 43 wounds). Weekly visits included an assessment of the patient's condition, photo documentation, wound debridement, and dressing. Quality of life and the pain degree were subjectively reported by patients. After SOC, 7 wounds were healed completely, 1 defect partially, and 28 defects remained unhealed. AM application led to the complete closure of 24 wounds, partial healing occurred in 10, and 9 remained unhealed. The degree of pain and the quality of life improved significantly in all patients after AM application. This study demonstrates the effectiveness of cryopreserved AM grafts in the healing of NHW of polymorbid patients and associated pain reduction.
- Publikační typ
- časopisecké články MeSH
This study aimed to evaluate the efficacy of cryopreserved amniotic membrane (AM) grafts in chronic wound healing, including the mean percentage of wound closure per one AM application, and to determine whether the healing efficiency differs between AM grafts obtained from different placentas. A retrospective study analyzing inter-placental differences in healing capacity and mean wound closure after the application of 96 AM grafts prepared from nine placentas. Only the placentas from which the AM grafts were applied to patients suffering from long-lasting non-healing wounds successfully healed by AM treatment were included. The data from the rapidly progressing wound-closure phase (p-phase) were analyzed. The mean efficiency for each placenta, expressed as an average of wound area reduction (%) seven days after the AM application (baseline, 100%), was calculated from at least 10 applications. No statistical difference between the nine placentas' efficiency was found in the progressive phase of wound healing. The 7-day average wound reduction in particular placentas varied from 5.70 to 20.99% (median from 1.07 to 17.75) of the baseline. The mean percentage of wound surface reduction of all analyzed defects one week after the application of cryopreserved AM graft was 12.17 ± 20.12% (average ± SD). No significant difference in healing capacity was observed between the nine placentas. The data suggest that if there are intra- and inter-placental differences in AM sheets' healing efficacy, they are overridden by the actual health status of the subject or even the status of its individual wounds.
- MeSH
- amnion * transplantace MeSH
- hojení ran MeSH
- kryoprezervace MeSH
- lidé MeSH
- placenta * MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cíl: Představit použití lidské kryokonzervované amniové membrány (AM) v léčbě chronických ran, specifikovat indikační kritéria pro její aplikaci, protokol aplikace a metodiku převazů. Dalším cílem je seznámení se souhrnnými výsledky studie léčby chronických nehojících se ran pomocí AM a s predikcí zhojení dle dynamiky léčby. Materiály a metody: Standardizace léčby pomocí kryokonzervované AM proběhla v rámci multicentrické studie ve třech klinických centrech. Pacientům s chronickými ranami, kteří se nehojili v průměru po dobu 34 měsíců (minimálně šest týdnů), byla aplikována AM, s pravidelnými vizitami po sedmi dnech. Výsledky: Z 35 pacientů s 43 ranami různé etiologie, bylo po aplikaci AM zcela zhojeno 24 ran (56 %), 10 ran bylo zhojeno částečně (> 50 % plochy rány) (23 %), 9 ran (21 %) se zhojit nepodařilo. Během léčby AM zaznamenali pacienti silný analgetický účinek. Sledování dynamiky hojení vedlo ke stanovení predikčního intervalu pro posouzení schopnosti rány zhojit se pomocí AM na 10–12 týdnů. Závěr: Léčba chronických ran pomocí AM přináší prospěch indikovaným pacientům, jak v akceleraci hojení, tak ve zlepšení kvality života, a to zejména snížení bolesti v oblasti rány.
Objective: This work presents the use of human cryopreserved amniotic membrane (AM) in the treatment of chronic wounds, specifying the indication criteria for its application, application protocol, and wound dressing methodology. At the same time, it presents the summary results of the study of the treatment of chronic non-healing wounds using AM with the prediction of healing according to the dynamics of the treatment. Materials and methods: Standardization of treatment using cryopreserved AM took place within the framework of a multicentre study in three specialist centres. Patients with chronic wounds that did not heal for an average of 34 months (min. six weeks) were treated with AM, with regular visits every seven days. The AM application was carried out 1–2 times in 14 days. Results: Out of 35 patients with 43 wounds of various etiologies, 24 wounds (56%) were completely healed after AM application, 10 wounds were partially healed (> 50% of the wound area) (23%), 9 wounds (21%) failed to heal. During AM treatment, patients experienced a strong analgesic effect. Monitoring the dynamics of healing led to the establishment of a prediction interval for assessing the ability of the wound to heal using AM at 10–12 weeks. Conclusion: The treatment of chronic wounds using AM brings benefits to the indicated patients, both in the acceleration of healing and in the improvement of the quality of life, especially in the reduction of pain in the wound area.
- MeSH
- amnion * fyziologie MeSH
- biologické krytí * klasifikace MeSH
- hojení ran MeSH
- kryoprezervace metody MeSH
- lidé MeSH
- membrány fyziologie MeSH
- placenta fyziologie MeSH
- rány a poranění ošetřování terapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Publikační typ
- abstrakt z konference MeSH
- Klíčová slova
- HyalEcaSan,
- MeSH
- hojení ran * účinky léků MeSH
- kyselina hyaluronová terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory vulvy radioterapie MeSH
- radiační poranění farmakoterapie komplikace MeSH
- sebepoškozování psychologie MeSH
- výsledek terapie MeSH
- ženské pohlavní orgány mikrobiologie patologie účinky léků MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
We evaluated the effect of the application of cryo-preserved amniotic membrane on the healing of 26 non-healing wounds (18 patients) with varying aetiologies and baseline sizes (average of 15.4 cm2 ), which had resisted the standard of care treatment for 6 to 456 weeks (average 88.8 weeks). Based on their average general responses to the application of cryo-preserved AM, we could differentiate three wound groups. The first healed group was characterised by complete healing (100% wound closure, maximum treatment period 38 weeks) and represented 62% of treated wounds. The wound area reduction of at least 50% was reached for all wounds in this group within the first 10 weeks of treatment. Exactly 19% of the studied wounds responded partially to the treatment (partially healed group), reaching less than 25% of closure in the first 10 weeks and 90% at maximum for extended treatment period (up to 78 weeks). The remaining 19% of treated wounds did not show any reaction to the AM application (unhealed defects). The three groups have different profiles of wound area reduction, which can be used as a guideline in predicting the healing prognosis of non-healing wounds treated with a cryo-preserved amniotic membrane.
- MeSH
- amnion * MeSH
- hojení ran * fyziologie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Východiska: Radiační dermatitida je velmi častou reakcí při radioterapii, postihuje s různou intenzitou přibližně 95 % pacientů. Je klíčové minimalizovat její vedlejší účinky. Pracovní skupina, která připravila tento dokument, zahrnuje lékaře, sestry, zástupce Společnosti radiační onkologie, biologie a fyziky ČLS JEP, Sekce podpůrné léčby a péče České onkologické společnosti ČLS JEP, České společnosti pro léčbu rány, Onkologické sekce České asociace sester a také dermatology. Článek byl schválen výbory těchto společností. Cíl: Doporučení pro preventivní a léčebnou péči o kůži pacientů podstupujících radioterapii v ČR.
Background: Radiation dermatitis is a very common reaction to radiotherapy, affecting approx. 95% of patients with varying intensity. It is crucial to minimize its side effects. The working group that prepared this document includes physicians, nurses, representatives of the Society for Radiation Oncology, Biology and Physics of the Czech Medical Association of J. E. Purkyně, the Supportive Treatment and Care Section of the Czech Society for Oncology of the Czech Medical Association of J. E. Purkyně, the Czech Wound Management Association, the Oncological Section of Czech Association of Nurses, and dermatologists. The document has been approved by the committees of these associations. Purpose: Recommendation for preventive and therapeutic skin care of patients undergoing radiotherapy in the Czech Republic.
- MeSH
- lidé MeSH
- péče o kůži metody MeSH
- radiodermatitida * prevence a kontrola terapie MeSH
- radioterapie škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
- Klíčová slova
- Mepilex xt,
- MeSH
- bakteriální nemoci kůže etiologie ošetřování MeSH
- bércové vředy * komplikace mikrobiologie ošetřování MeSH
- hojení ran MeSH
- lidé MeSH
- obvazy MeSH
- Check Tag
- lidé MeSH
