Application of paste-type acellular dermal matrix in hard-to-heal wounds. (2nd May 2021)

• Record Type: Journal Article
• Authors: Kim, Sang Wha; Shim, Hyung Sup; Lee, Jihye; Kim, Youn Hwan
• Is Part Of: Journal of wound care. Volume 30:Number 5(2021)
• Page Start: 414
• Page End: 418
• Publication Date: 2021-05-02
• Subjects: acellular dermis -- dermal matrix -- extracellular matrix -- hard-to-heal wounds -- ulcer -- wound -- wound healing; Wounds and injuries -- Treatment -- Periodicals; Wound healing -- Periodicals; 617.1
• DOI: 10.12968/jowc.2021.30.5.414
• Languages: English
• ISSNs: 0969-0700

Abstract

Abstract : Objective: The extracellular matrix (ECM) is one of the most important elements in wound healing. Absence or dysfunction of the ECM may impair wound healing. The application of acellular dermal matrix (ADM) as a substitute for ECM has been suggested. This study investigated the clinical application and wound healing effects of a paste-type ADM in patients presenting with hard-to-heal wounds due to various causes. Method: Patients with a hard-to-heal wound for >1 month, from September 2017 to February 2019, were included in this study. After debridement, the paste-type ADM was applied, at zero (baseline), two and four weeks. After application of the paste-type ADM, a conventional dressing was applied using polyurethane foam. Wound size, the formation of granulation tissue, re-epithelialisation, complete healing and adverse events were recorded at zero (baseline), one, two, four, eight and 12 weeks after the initial treatment. Results: A total of 18 patients took part (eight male, 10 female, mean age of 56±16.16 years). The mean wound area decreased from 17.42±10.04cm 2 to 12.73±7.60cm 2 by week one (p<0.05), to 10.16±7.00 by week two (p<0.0005), to 5.56±5.25 by week four (p<0.0001), to 2.77±5.15 by week eight (p<0.0001) and to 2.07±4.78 by week 12 (p<0.0001). The number of patients with >75% re-epithelialisation increased from two (11.1%) at two weeks to five (27.8%) at four weeks, to 11 (61.1%) at eight weeks and to 13 (72.2%) at 12 weeks. The number of patients showing complete wound healing was two (11.1%) at four weeks, nine (50.0%) at eight weeks and 12 (66.7%) at 12 weeks. No adverse events were reported during treatment. Conclusion: The paste-type ADM used in this study is a viable option for facilitating wound healing; it can shorten hospitalisation, and promote a faster recovery and return to normal life activities.