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间充质干细胞和联合双侧股薄肌皮瓣的再生治疗用于肛门鳞状细胞癌背景下伤口感染的会阴重建

英文原题:Mesenchymal Stem Cells and Regenerative Therapy with Bilateral Gracilis Flaps for Perineal Reconstruction of a Wound Infection in the Setting of Anal Squamous Cell Carcinoma.

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Mesenchymal Stem Cells and Regenerative Therapy with Bilateral Gracilis Flaps for Perineal Reconstruction of a Wound Infection in the Setting of Anal Squamous Cell Carcinoma.

PubMed 2023/08/01(内容时间) Adv Skin Wound Care Q3 · IF 1.5(JCR 2025)

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中文摘要

全球有许多HIV/AIDS患者,疾病负担较高。HIV/AIDS患者可能发生严重伤口感染,常需采用皮瓣重建,给外科治疗带来挑战。过去5年间,间充质干细胞(MSC)因能够有效促进细胞有丝分裂而被用于全身组织再生治疗。据作者所知,臀部肌皮瓣坏死后,在会阴创面重建中进行MSC移植尚未见文献报道。此外,既往接受放疗的肛门鳞状细胞癌患者合并AIDS时,联合使用MSC和再生医学产品也尚无报道。本病例报告一名60岁患者,其会阴受区因既往放疗出现并发症。病情还因盆腔铜绿假单胞菌器官腔隙感染而复杂化,导致腹直肌垂直肌皮瓣和股薄肌肌皮瓣失败。患者因此接受多次手术清创以控制感染,并使用MSC、胎牛真皮、猪膀胱脱细胞基质异种移植物及其他再生医学产品,最终取得良好临床效果。本文还提供了相关操作流程,供未来应用和复制。

展开英文摘要原文

Many patients are affected by HIV/AIDS, and these conditions are highly prevalent worldwide. Patients with HIV/AIDS can experience debilitating wound infections that often require flap reconstruction and become challenging for surgeons to treat.

In the past 5 years, mesenchymal stem cells have been tested and used as regenerative therapy to promote the growth of tissues throughout the body because of their ability to successfully promote cellular mitogenesis. To the authors' knowledge, the use of mesenchymal stem cell grafting following necrosis of a myocutaneous gracilis flap (as part of perineal wound reconstruction) has never been reported in the literature.

In addition, the use of mesenchymal stem cells and regenerative medicine combined in the setting of squamous cell carcinoma of the anus with prior radiation (along with comorbid AIDS) has not been previously documented. In this report, the authors outline the case of a 60-year-old patient who had a recipient bed (perineum) complication from prior radiation therapy.

Complicating the clinical picture, the patient also developed a Pseudomonal organ space infection of the pelvis leading to the failure of a vertical rectus abdominis myocutaneous flap and myocutaneous gracilis flaps.

As a result, the patient underwent serial operative debridements for source control, with the application of mesenchymal stem cells, fetal bovine dermis, porcine urinary bladder xenograft, and other regenerative medicine products, achieving a highly successful clinical outcome. A procedural description for future use and replication of this method is provided.

论文信息

作者
Garcia MF、Tiwari KK、Gendreau JL、Burgess PL、Taupin P、Martin ED
第一作者单位
At Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia, USA, Matthew F. Garcia, MD, is Transitional Year Resident; Kirti K. Tiwari, MS, is Chief, Research Operations; Julian L. Gendreau, MD, is Transitional Year Resident; and Pamela L. Burgess, MD, is Chief, General Surgery. Philippe Taupin, PhD, is Senior Manager, Medical Affairs, Integra LifeSciences, Princeton, New Jersey. Also at Dwight D. Eisenhower Army Medical Center, Eric D. Martin, DO, is Chief, Cardiovascular Surgery. Dr Taupin is an employee of Integra LifeSciences Corporation. The authors have disclosed no other financial relationships related to this article. Submitted March 5, 2022; accepted in revised form September 9, 2022.United States
文献类型
病例报告
期刊
Advances in skin & wound care2023 Aug 1
原文标识
PubMed 37471451 · DOI 10.1097/ASW.0000000000000009