当前位置： SCI文献检索 > Advances in Wound Care期刊下所有文献 > Prolotherapy: Potential for the Treatment of Chronic Wounds?

Prolotherapy: Potential for the Treatment of Chronic Wounds?

Abstract：

:Significance: Chronic skin ulcers, including venous, diabetic, and pressure ulcers, constitute a major health care burden, affecting 2-6 million people in the United States alone, with projected increases in incidence owing to the aging population and rising epidemic of diabetes. The ulcers are often accompanied by pain. Standard of care fails to heal ∼50% of diabetic foot ulcers and 25% of venous leg ulcers. Even advanced therapies do not heal >60%. Thus there is an unmet need for novel therapies that promote healing and also address the concomitant pain issue. Recent Advances: Prolotherapy involves injection of small amounts of an irritant material to the site of degenerated or painful joints, ligaments, and tendons. Multiple irritants are reported to be efficacious, but the focus here is on dextrose prolotherapy. In vitro and in vivo studies support translation to clinical use. Concentrations as low as 5% dextrose have resulted in production of growth factors that have critical roles in repair. Numerous clinical trials report pro-reparative effects of dextrose prolotherapy in joint diseases, tendon, and ligament damage, and for painful musculoskeletal issues. However, most of the studies have limitations that result in low-quality evidence. Critical Issues: The preclinical data support a role for dextrose prolotherapy in promoting tissue repair that is required for healing chronic wounds and ameliorating the associated pain. Critical issues include provision of evidence of efficacy in human chronic wounds. Another potential obstacle is limitation of reimbursement by third-party payers for a therapy with as yet limited evidence. Future Directions: Preclinical studies in models of chronic wounds would support clinical translation. As dextrose prolotherapy has some mechanistic similarities to already approved honey therapies, it may have a shortened pathway for clinical translation. The gold standard for widespread adoption would be a well-designed clinical trial.

journal_name

Adv Wound Care (New Rochelle)

journal_title

Advances in wound care

authors

Siadat AH,Isseroff RR

doi

10.1089/wound.2018.0866

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

160-167

issue

eissn

2162-1918

issn

2162-1934

pii

10.1089/wound.2018.0866

journal_volume

pub_type

杂志文章,评审

在线工具

Prolotherapy: Potential for the Treatment of Chronic Wounds?