Failure rates of artificial dermis products in treatment of diabetic foot ulcer: A systematic review and network meta-analysis

Autor:	Pauline Kangambega, Huidi Tchero, Farid Bekara, Christian Herlin, Luc Téot, Fluieraru Sergiu
Rok vydání:	2017
Předmět:	medicine.medical_specialty business.industry medicine.medical_treatment 030209 endocrinology & metabolism Dermatology medicine.disease Diabetic foot Surgery law.invention Clinical trial 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Diabetic foot ulcer Randomized controlled trial law Internal medicine Meta-analysis Relative risk medicine Skin grafting business Cohort study
Zdroj:	Wound Repair and Regeneration. 25:691-696
ISSN:	1067-1927
DOI:	10.1111/wrr.12554
Popis:	Diabetic foot ulcer (DFU) is a frequent complication in diabetic patients, occurring in up to 25% of those affected. Among the treatments available to clinicians, the use of bioengineered skin substitutes is an attractive alternative. Artificial dermis functions as a matrix, covering the wound and supporting healing and reconstruction of the lost tissue. This study was aimed at reviewing the use of five regeneration matrices (namely, Integra, Nevelia, Matriderm, Pelnac, and Renoskin) as reported by clinical trials. We searched Medline, Embase, ISI Web of Science, Scopus, and Cochrane Central Register of Controlled Trials databases for relevant studies. Risk of failure rates was analysed by relative risk ratio method and complete ulcer healing was studied using network meta-analysis. Thirteen studies (12 randomized clinical trials and one cohort study) were eligible for analysis. The network meta-analysis based on a single study for Matriderm and 12 studies for other products showed that Matriderm was statistically inferior in achieving complete ulcer healing, as compared to all other products combined. In the second phase analysis, which was limited to three studies using artificial dermis products, there was a 57% reduction in the risk of reepithelialization failure for DFU patients who used Matriderm or Pelnac, compared to those who used Pelnac with basic fibroblast growth factor spray or skin grafting. The data showed an overall low failure rate suggesting that these bioengineered skin products provide a suitable support and microenvironment for healing of DFUs with low ulcer recurrence rates. This systematic review with meta-analysis highlights the pressing need for more studies investigating the safety, efficacy and failure rates of regeneration matrices in the treatment of DFUs.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::2c768771cc279d6e1ec7f4c279016c77 https://doi.org/10.1111/wrr.12554 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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