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  • Title: A multicenter retrospective study comparing a polylactic acid CAMP with intact fish skin graft or a collagen dressing in the management of diabetic foot ulcers and venous leg ulcers.
    Author: Liden BA, Liu T, Regulski M, Foster M, DeLeon R, Palazzi G, Ramirez-GarciaLuna JL.
    Journal: Wounds; 2024 Sep; 36(9):297-302. PubMed ID: 39378347.
    Abstract:
    BACKGROUND: Venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs) are examples of chronic wounds that pose an ongoing health care challenge. Despite significant progress in managing such wounds, challenges persist that require innovative solutions. Cellular, acellular, and matrix-like products (CAMPs) are advanced therapies designed to facilitate chronic wound healing. Polylactic acid (PLA) is a synthetic material used in alloplastic CAMPs that has shown promise in the management of burns and traumatic injuries. OBJECTIVE: To retrospectively assess the effect of PLA in promoting chronic wound healing compared with 2 other well-established CAMPs. MATERIALS AND METHODS: This retrospective chart review, which was conducted in 3 high-volume wound care clinics, aimed to compare the efficacy of 2 advanced wound care products vs a PLA alloplastic CAMP in promoting DFU and VLU closure. The study included 131 wounds treated with a non-CAMP collagen dressing, fish skin grafts (FSGs), or PLA matrices. Inclusion criteria included single Wagner grade 1 or 2 DFUs or Clinical-Etiology-Anatomy-Pathophysiology classification score C6 VLUs, present for at least 12 to 52 weeks, and measuring between 1 cm² and 20 cm². Patients received weekly treatments with 1 of 3 CAMPs, along with standard care. The primary outcome was time to achieve full healing, and the secondary outcome was the proportion of ulcers healed at 12 weeks. RESULTS: The PLA alloplastic CAMP demonstrated superior outcomes, with a 50% and 20% reduction in time to heal DFUs compared with collagen dressings and FSG, respectively (P < .001). For VLUs, PLA exhibited even more impressive results, achieving 95% and 40% reduction compared with collagen and FSG, respectively (P < .001). PLA allografts displayed a 55% higher rate of full healing by 12 weeks compared with collagen dressings, and a 26% higher rate compared with FSG (P < .001). CONCLUSION: This study highlights the unique attributes of PLA for achieving wound closure. PLA-based alloplastic CAMPs are promising treatments, offering rapid healing, increased closure rates, and multifaceted benefits for wound healing.
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