Protocol-driven Therapy for Lower Extremity Ulcers: A Case Series Supporting the Use of Porcine Intestine Extracellular Matrix
Introducción. Las úlceras crónicas suponen un reto para la salud pública. Por ello, es imperativo conocer y evaluar nuevas estrategias de manejo que contribuyan a la calidad de vida de los pacientes y optimicen los recursos sanitarios. pacientes y optimicen los recursos sanitarios. En este estudio s...
- Autores:
-
Cáceres Rivera, Diana Isabel
Pulido Montes, María Andreina
Jaimes Carvajal, Nelly Esperanza
- Tipo de recurso:
- Article of investigation
- Fecha de publicación:
- 2023
- Institución:
- Universidad Cooperativa de Colombia
- Repositorio:
- Repositorio UCC
- Idioma:
- OAI Identifier:
- oai:repository.ucc.edu.co:20.500.12494/49052
- Acceso en línea:
- https://hdl.handle.net/20.500.12494/49052
- Palabra clave:
- Matriz extracelular
Heridas
Úlcera
Extremidades inferiores
Técnica de cierre de heridas
Extracellular matrix
Injuries
lower
Extremity ulcer
wound closure techniques
- Rights
- openAccess
- License
- NINGUNA
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Protocol-driven Therapy for Lower Extremity Ulcers: A Case Series Supporting the Use of Porcine Intestine Extracellular Matrix |
| title |
Protocol-driven Therapy for Lower Extremity Ulcers: A Case Series Supporting the Use of Porcine Intestine Extracellular Matrix |
| spellingShingle |
Protocol-driven Therapy for Lower Extremity Ulcers: A Case Series Supporting the Use of Porcine Intestine Extracellular Matrix Matriz extracelular Heridas Úlcera Extremidades inferiores Técnica de cierre de heridas Extracellular matrix Injuries lower Extremity ulcer wound closure techniques |
| title_short |
Protocol-driven Therapy for Lower Extremity Ulcers: A Case Series Supporting the Use of Porcine Intestine Extracellular Matrix |
| title_full |
Protocol-driven Therapy for Lower Extremity Ulcers: A Case Series Supporting the Use of Porcine Intestine Extracellular Matrix |
| title_fullStr |
Protocol-driven Therapy for Lower Extremity Ulcers: A Case Series Supporting the Use of Porcine Intestine Extracellular Matrix |
| title_full_unstemmed |
Protocol-driven Therapy for Lower Extremity Ulcers: A Case Series Supporting the Use of Porcine Intestine Extracellular Matrix |
| title_sort |
Protocol-driven Therapy for Lower Extremity Ulcers: A Case Series Supporting the Use of Porcine Intestine Extracellular Matrix |
| dc.creator.fl_str_mv |
Cáceres Rivera, Diana Isabel Pulido Montes, María Andreina Jaimes Carvajal, Nelly Esperanza |
| dc.contributor.author.none.fl_str_mv |
Cáceres Rivera, Diana Isabel Pulido Montes, María Andreina Jaimes Carvajal, Nelly Esperanza |
| dc.subject.none.fl_str_mv |
Matriz extracelular Heridas Úlcera Extremidades inferiores Técnica de cierre de heridas |
| topic |
Matriz extracelular Heridas Úlcera Extremidades inferiores Técnica de cierre de heridas Extracellular matrix Injuries lower Extremity ulcer wound closure techniques |
| dc.subject.other.none.fl_str_mv |
Extracellular matrix Injuries lower Extremity ulcer wound closure techniques |
| description |
Introducción. Las úlceras crónicas suponen un reto para la salud pública. Por ello, es imperativo conocer y evaluar nuevas estrategias de manejo que contribuyan a la calidad de vida de los pacientes y optimicen los recursos sanitarios. pacientes y optimicen los recursos sanitarios. En este estudio se evaluó la eficacia de un nuevo protocolo de tratamiento de heridas crónicas que incluye ECM de intestino porcino. ECM. Materiales y métodos. Veintiún pacientes con heridas crónicas de diferentes etiologías. Se aplicó un nuevo protocolo de cicatrización que ECM porcina durante un período máximo de 12 semanas. semanas. El seguimiento incluyó una visita semanal para fotografiar las úlceras y registrar su tamaño. Resultados. El tamaño de las heridas oscilaba entre 0,5 cm2 y 10 cm2 al inicio del estudio. estudio. Dos de los 21 pacientes que iniciaron el protocolo se retiraron, 1 por protocolo y 1 por complicaciones de salud no relacionadas con el estudio. estudio. La mayoría de las lesiones se produjeron en las extremidades inferiores. Todos los pacientes que completaron el Todos los pacientes que completaron el protocolo de tratamiento consiguieron la regeneración y el cierre total de la herida en un plazo medio de 4,5 semanas. una media de 4,5 semanas. El porcentaje medio de cierre fue del 100% a las 8 semanas, sin EA. Conclusiones. Los resultados de este estudio demuestran la eficacia de un protocolo de tratamiento de heridas basado en pruebas para lograr una regeneración tisular completa y segura en un breve periodo de tiempo. Traducción realizada con la versión gratuita del traductor www.DeepL.com/Translator |
| publishDate |
2023 |
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2023-03-28T21:41:27Z |
| dc.date.available.none.fl_str_mv |
2023-03-28T21:41:27Z |
| dc.date.issued.none.fl_str_mv |
2023-01-01 |
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Artículos Científicos |
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Diana Isabel Cáceres, PhD1; Leydi Castro, RN1; Nelly Esperanza Jaimes, RN, MsC1; Luis Fernando Orduz, MD2; and Maria Andreina Pulido, RN, MsC1 |
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https://hdl.handle.net/20.500.12494/49052 |
| identifier_str_mv |
Diana Isabel Cáceres, PhD1; Leydi Castro, RN1; Nelly Esperanza Jaimes, RN, MsC1; Luis Fernando Orduz, MD2; and Maria Andreina Pulido, RN, MsC1 |
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10.25270/wnds/21020 |
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Agren MS, Werthén M. The extracellular matrix in wound healing: a closer look at therapeutics for chronic wounds. Int J Low Extrem Wounds. 2007;6(2):82-97. doi:10.1177/1534734607301394 Barrientos S, Stojadinovic O, Golinko MS, Brem H, Tomic-Canic M. Growth factors and cytokines in wound healing. Wound Repair Regen. 2008;16(5):585-601. doi:10.1111/j.1524- 475X.2008.00410.x Barwell JR, Taylor M, Deacon J, et al. Surgical correction of isolated superficial venous reflux reduces long-term recurrence rate in chronic venous leg ulcers. Eur J Vasc Endovasc Surg. 2000;20(4):363-368. doi:10.1053/ejvs.2000.1196 Barwell JR, Davies CE, Deacon J, et al. Comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR study): randomised controlled trial. Lancet. 2004;363(9424):1854-1859. doi:10.1016/ S0140-6736(04)16353-8 Gómez PB, Martínez MB, Pérez RC, et al. Situación actual sobre el manejo de heridas agudas y crónicas en España: Estudio ATENEA. Gerokomos. 2013;24(1):27-31. Available at: http://scielo.isciii.es/scielo.php?script=sci_ arttext&pid=S1134-928X2013000100006&lng= es. https://dx.doi.org/10.4321/S1134- 928X2013000100006. Bohn G, Liden B, Schultz G, Yang Q, Gibson DJ. Ovine-based collagen matrix dressing: nextgeneration collagen dressing for wound care. Adv Wound Care (New Rochelle). 2016;5(1):1-10. doi:10.1089/wound.2015.0660 Brown-Etris M, Cutshall WD, Hiles MC. A new biomaterial derived from small intestine submucosa and developed into a wound matrix device. Wounds. 2002;14(4):150-166. Brown-Etris M, Milne CT, Hodde JP. An extracellular matrix graft (Oasis® wound matrix) for treating full-thickness pressure ulcers: a randomized clinical trial. J Tissue Viability. 2019;28(1):21-26. doi:10.1016/j.jtv.2018.11.001 Capella-Monsonís H, Tilbury MA, Wall JG, Zeugolis DI. Porcine mesothelium matrix as a biomaterial for wound healing applications. Mater Today Bio. 2020;7:100057. Cazzell SM, Lange DL, Dickerson JE Jr, Slade HB. The management of diabetic foot ulcers with porcine small intestine submucosa tri-layer matrix: a randomized controlled trial. Adv Wound Care (New Rochelle). 2015;4(12):711-718. doi:10.1089/wound.2015.0645 Demling RH. Niezgoda JA, Haraway GD, Mostow EN. Small intestinal submucosa wound matrix and full-thickness venous ulcers: preliminary results. Wounds. 2004;16(1):18–22. Margolis DJ, Bilker W, Santanna J, Baumgarten M. Venous leg ulcer: incidence and prevalence in the elderly. J Am Acad Dermatol. 2002;46(3):381- 386. doi:10.1067/mjd.2002.121739 Falanga V, Sabolinski M. A bilayered living skin construct (APLIGRAF) accelerates complete closure of hard-to-heal venous ulcers. Wound Repair Regen. 1999;7(4):201-207. doi:10.1046/ j.1524-475x.1999.00201.x Fowkes FG, Evans CJ, Lee AJ. Prevalence and risk factors of chronic venous insufficiency. Angiology. 2001;52 Suppl 1:S5-S15. doi:10.1177/0003319701052001S02 Frykberg RG, Banks J. Challenges in the treatment of chronic wounds. Adv Wound Care (New Rochelle). 2015;4(9):560-582. doi:10.1089/ wound.2015.0635 Gillespie DL, Writing Group III of the Pacific Vascular Symposium 6, Kistner B, et al. Venous ulcer diagnosis, treatment, and prevention of recurrences. J Vasc Surg. 2010;52(5 Suppl):8S-14S. doi:10.1016/j.jvs.2010.05.068 Gould L, Stuntz M, Giovannelli M, et al. Wound Healing Society 2015 update on guidelines for pressure ulcers. Wound Repair Regen. 2016;24(1):145-162. doi:10.1111/wrr.12396 Graham ID, Harrison MB, Nelson EA, Lorimer K, Fisher A. Prevalence of lower-limb ulceration: a systematic review of prevalence studies. Adv Skin Wound Care. 2003;16(6):305-316. doi:10.1097/00129334-200311000-00013 Griffin L, Carter MJ, D'Agostino R Jr, D'Agostino McGowan L. Comparative effectiveness of two collagen-containing dressings: oxidized regenerated cellulose (ORC)/collagen/silver-ORC dressing versus ovine collagen extracellular matrix. Wounds. 2019;31(11):E73-E76. Jones RE, Foster DS, Longaker MT. Management of chronic wounds-2018. JAMA. 2018;320(14):1481-1482. doi:10.1001/ jama.2018.12426 Lullove EJ. Use of ovine-based collagen extracellular matrix and gentian violet/methylene blue antibacterial foam dressings to help improve clinical outcomes in lower extremity wounds: a retrospective cohort study. Wounds. 2017;29(4):107-114 Mostow EN, Haraway GD, Dalsing M, Hodde JP, King D, OASIS Venus Ulcer Study Group. Effectiveness of an extracellular matrix graft (OASIS Wound Matrix) in the treatment of chronic leg ulcers: a randomized clinical trial. J Vasc Surg. 2005;41(5):837-843. doi:10.1016/j.jvs.2005.01.042 Norman G, Westby MJ, Rithalia AD, Stubbs N, Soares MO, Dumville JC. Dressings and topical agents for treating venous leg ulcers. Cochrane Database Syst Rev. 2018;6(6):CD012583. Published 2018 Jun 15. doi:10.1002/14651858.CD012583.pub2 Posnett J, Gottrup F, Lundgren H, Saal G. The resource impact of wounds on health-care providers in Europe. J Wound Care. 2009;18(4):154- 161. doi:10.12968/jowc.2009.18.4.41607 Bryant R, Nix D. Acute and Chronic Wounds: Current Management Concept. 3rd ed. Mosby; 2007. Raizman R, Hill R, Woo K. Prospective multicenter evaluation of an advanced extracellularmatrix for wound management. Adv Skin Wound Care. 2020;33(8):437-444. doi:10.1097/01. ASW.0000667052.74087.d6 Rice JB, Desai U, Cummings AKG, Birnbaum HG. Medical, drug, and work-loss costs of venous leg ulcers. Value in Health. 2013;16.3:A73. doi:10.1016/j.jval.2013.03.329 Robson MC, Steed DL, Franz MG. Wound healing: biologic features and approaches to maximize healing trajectories. Curr Probl Surg. 2001;38(2):72-140. doi:10.1067/msg.2001.111167 Romanelli M, Gilligan AM, Waycaster CR, Dini V. Difficult-to-heal wounds of mixed arterial/ venous and venous etiology: a cost-effectiveness analysis of extracellular matrix. Clinicoecon Outcomes Res. 2016;8:153-161. doi:10.2147/CEOR. S104067 Schultz GS, Wysocki A. Interactions between extracellular matrix and growth factors in wound healing. Wound Repair Regen. 2009;17(2): 153-162. doi:10.1111/j.1524-475X.2009.00466.x Thomas S. Surgical Dressings and Wound Management. Medetec, Cardiff; 2010. Urciuolo F, Casale C, Imparato G, Netti PA. Bioengineered skin substitutes: the role of extracellular matrix and vascularization in the healing of deep wounds. J Clin Med. 2019;8(12):2083. doi:10.3390/jcm8122083 Chandler LA, Alvarez OM, Blume PA, et al. Wound conforming matrix containing purified homogenate of dermal collagen promotes healing of diabetic neuropathic foot ulcers: comparative analysis versus standard of care. Adv Wound Care (New Rochelle). 2020;9(2):61-67. doi:10.1089/wound.2019.1024 Westby MJ, Dumville JC, Soares MO, Stubbs N, Norman G. Dressings and topical agents for treating pressure ulcers. Cochrane Database Syst Rev. 2017;6(6):CD011947. doi:10.1002/14651858. CD011947.pub2 |
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Cáceres Rivera, Diana IsabelPulido Montes, María AndreinaJaimes Carvajal, Nelly Esperanza2023-03-28T21:41:27Z2023-03-28T21:41:27Z2023-01-01https://hdl.handle.net/20.500.12494/49052Diana Isabel Cáceres, PhD1; Leydi Castro, RN1; Nelly Esperanza Jaimes, RN, MsC1; Luis Fernando Orduz, MD2; and Maria Andreina Pulido, RN, MsC1Introducción. Las úlceras crónicas suponen un reto para la salud pública. Por ello, es imperativo conocer y evaluar nuevas estrategias de manejo que contribuyan a la calidad de vida de los pacientes y optimicen los recursos sanitarios. pacientes y optimicen los recursos sanitarios. En este estudio se evaluó la eficacia de un nuevo protocolo de tratamiento de heridas crónicas que incluye ECM de intestino porcino. ECM. Materiales y métodos. Veintiún pacientes con heridas crónicas de diferentes etiologías. Se aplicó un nuevo protocolo de cicatrización que ECM porcina durante un período máximo de 12 semanas. semanas. El seguimiento incluyó una visita semanal para fotografiar las úlceras y registrar su tamaño. Resultados. El tamaño de las heridas oscilaba entre 0,5 cm2 y 10 cm2 al inicio del estudio. estudio. Dos de los 21 pacientes que iniciaron el protocolo se retiraron, 1 por protocolo y 1 por complicaciones de salud no relacionadas con el estudio. estudio. La mayoría de las lesiones se produjeron en las extremidades inferiores. Todos los pacientes que completaron el Todos los pacientes que completaron el protocolo de tratamiento consiguieron la regeneración y el cierre total de la herida en un plazo medio de 4,5 semanas. una media de 4,5 semanas. El porcentaje medio de cierre fue del 100% a las 8 semanas, sin EA. Conclusiones. Los resultados de este estudio demuestran la eficacia de un protocolo de tratamiento de heridas basado en pruebas para lograr una regeneración tisular completa y segura en un breve periodo de tiempo. Traducción realizada con la versión gratuita del traductor www.DeepL.com/TranslatorIntroduction. Chronic ulcers pose a public health challenge. Thus, it is imperative to be aware of and assess new management strategies that contribute to patient quality of life and optimize health resources. This study evaluated the efficacy of a new protocol for chronic wound management that includes porcine intestine ECM. Materials and Methods. Twenty-one patients with chronic wounds of different etiologies were included in this study. A new healing protocol that incorporates the use of porcine ECM was initiated for a maximum period of 12 weeks. Follow-up included a weekly visit to photograph the ulcers and record their size. Results. Wounds ranged in size from 0.5 cm2 to 10 cm2 at the outset of the study. Two of the 21 patients who started the protocol withdrew, 1 for nonadherence to the protocol and 1 for health complications unrelated to the study. Most lesions occurred in the lower limbs. All patients who completed the treatment protocol achieved wound regeneration and total wound closure within an average of 4.5 weeks. The average percentage closure rate was 100% at 8 weeks, with no AEs. Conclusions. The findings of this study demonstrate the efficacy of an evidence-based wound management protocol in achieving safe, complete tissue regeneration in a short period of time.dianai.caceres@ucc.edu.coMariaa.pulido@campusucc.edu.coNelly.jaimes@ucc.edu.co6p.Universidad Cooperativa de Colombia, Facultad de Ciencias de la Salud, Enfermería, BucaramangaEnfermeríaBucaramanga10.25270/wnds/21020Agren MS, Werthén M. The extracellular matrix in wound healing: a closer look at therapeutics for chronic wounds. Int J Low Extrem Wounds. 2007;6(2):82-97. doi:10.1177/1534734607301394Barrientos S, Stojadinovic O, Golinko MS, Brem H, Tomic-Canic M. Growth factors and cytokines in wound healing. Wound Repair Regen. 2008;16(5):585-601. doi:10.1111/j.1524- 475X.2008.00410.xBarwell JR, Taylor M, Deacon J, et al. Surgical correction of isolated superficial venous reflux reduces long-term recurrence rate in chronic venous leg ulcers. Eur J Vasc Endovasc Surg. 2000;20(4):363-368. doi:10.1053/ejvs.2000.1196Barwell JR, Davies CE, Deacon J, et al. Comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR study): randomised controlled trial. Lancet. 2004;363(9424):1854-1859. doi:10.1016/ S0140-6736(04)16353-8Gómez PB, Martínez MB, Pérez RC, et al. Situación actual sobre el manejo de heridas agudas y crónicas en España: Estudio ATENEA. Gerokomos. 2013;24(1):27-31. Available at: http://scielo.isciii.es/scielo.php?script=sci_ arttext&pid=S1134-928X2013000100006&lng= es. https://dx.doi.org/10.4321/S1134- 928X2013000100006.Bohn G, Liden B, Schultz G, Yang Q, Gibson DJ. Ovine-based collagen matrix dressing: nextgeneration collagen dressing for wound care. Adv Wound Care (New Rochelle). 2016;5(1):1-10. doi:10.1089/wound.2015.0660Brown-Etris M, Cutshall WD, Hiles MC. A new biomaterial derived from small intestine submucosa and developed into a wound matrix device. Wounds. 2002;14(4):150-166.Brown-Etris M, Milne CT, Hodde JP. An extracellular matrix graft (Oasis® wound matrix) for treating full-thickness pressure ulcers: a randomized clinical trial. J Tissue Viability. 2019;28(1):21-26. doi:10.1016/j.jtv.2018.11.001Capella-Monsonís H, Tilbury MA, Wall JG, Zeugolis DI. Porcine mesothelium matrix as a biomaterial for wound healing applications. Mater Today Bio. 2020;7:100057.Cazzell SM, Lange DL, Dickerson JE Jr, Slade HB. The management of diabetic foot ulcers with porcine small intestine submucosa tri-layer matrix: a randomized controlled trial. Adv Wound Care (New Rochelle). 2015;4(12):711-718. doi:10.1089/wound.2015.0645Demling RH. Niezgoda JA, Haraway GD, Mostow EN. Small intestinal submucosa wound matrix and full-thickness venous ulcers: preliminary results. Wounds. 2004;16(1):18–22.Margolis DJ, Bilker W, Santanna J, Baumgarten M. Venous leg ulcer: incidence and prevalence in the elderly. J Am Acad Dermatol. 2002;46(3):381- 386. doi:10.1067/mjd.2002.121739Falanga V, Sabolinski M. A bilayered living skin construct (APLIGRAF) accelerates complete closure of hard-to-heal venous ulcers. Wound Repair Regen. 1999;7(4):201-207. doi:10.1046/ j.1524-475x.1999.00201.xFowkes FG, Evans CJ, Lee AJ. Prevalence and risk factors of chronic venous insufficiency. Angiology. 2001;52 Suppl 1:S5-S15. doi:10.1177/0003319701052001S02Frykberg RG, Banks J. Challenges in the treatment of chronic wounds. Adv Wound Care (New Rochelle). 2015;4(9):560-582. doi:10.1089/ wound.2015.0635Gillespie DL, Writing Group III of the Pacific Vascular Symposium 6, Kistner B, et al. Venous ulcer diagnosis, treatment, and prevention of recurrences. J Vasc Surg. 2010;52(5 Suppl):8S-14S. doi:10.1016/j.jvs.2010.05.068Gould L, Stuntz M, Giovannelli M, et al. Wound Healing Society 2015 update on guidelines for pressure ulcers. Wound Repair Regen. 2016;24(1):145-162. doi:10.1111/wrr.12396Graham ID, Harrison MB, Nelson EA, Lorimer K, Fisher A. Prevalence of lower-limb ulceration: a systematic review of prevalence studies. Adv Skin Wound Care. 2003;16(6):305-316. doi:10.1097/00129334-200311000-00013Griffin L, Carter MJ, D'Agostino R Jr, D'Agostino McGowan L. Comparative effectiveness of two collagen-containing dressings: oxidized regenerated cellulose (ORC)/collagen/silver-ORC dressing versus ovine collagen extracellular matrix. Wounds. 2019;31(11):E73-E76.Jones RE, Foster DS, Longaker MT. Management of chronic wounds-2018. JAMA. 2018;320(14):1481-1482. doi:10.1001/ jama.2018.12426Lullove EJ. Use of ovine-based collagen extracellular matrix and gentian violet/methylene blue antibacterial foam dressings to help improve clinical outcomes in lower extremity wounds: a retrospective cohort study. Wounds. 2017;29(4):107-114Mostow EN, Haraway GD, Dalsing M, Hodde JP, King D, OASIS Venus Ulcer Study Group. Effectiveness of an extracellular matrix graft (OASIS Wound Matrix) in the treatment of chronic leg ulcers: a randomized clinical trial. J Vasc Surg. 2005;41(5):837-843. doi:10.1016/j.jvs.2005.01.042Norman G, Westby MJ, Rithalia AD, Stubbs N, Soares MO, Dumville JC. Dressings and topical agents for treating venous leg ulcers. Cochrane Database Syst Rev. 2018;6(6):CD012583. Published 2018 Jun 15. doi:10.1002/14651858.CD012583.pub2Posnett J, Gottrup F, Lundgren H, Saal G. The resource impact of wounds on health-care providers in Europe. J Wound Care. 2009;18(4):154- 161. doi:10.12968/jowc.2009.18.4.41607Bryant R, Nix D. Acute and Chronic Wounds: Current Management Concept. 3rd ed. Mosby; 2007.Raizman R, Hill R, Woo K. Prospective multicenter evaluation of an advanced extracellularmatrix for wound management. Adv Skin Wound Care. 2020;33(8):437-444. doi:10.1097/01. ASW.0000667052.74087.d6Rice JB, Desai U, Cummings AKG, Birnbaum HG. Medical, drug, and work-loss costs of venous leg ulcers. Value in Health. 2013;16.3:A73. doi:10.1016/j.jval.2013.03.329Robson MC, Steed DL, Franz MG. Wound healing: biologic features and approaches to maximize healing trajectories. Curr Probl Surg. 2001;38(2):72-140. doi:10.1067/msg.2001.111167Romanelli M, Gilligan AM, Waycaster CR, Dini V. Difficult-to-heal wounds of mixed arterial/ venous and venous etiology: a cost-effectiveness analysis of extracellular matrix. Clinicoecon Outcomes Res. 2016;8:153-161. doi:10.2147/CEOR. S104067Schultz GS, Wysocki A. Interactions between extracellular matrix and growth factors in wound healing. Wound Repair Regen. 2009;17(2): 153-162. doi:10.1111/j.1524-475X.2009.00466.xThomas S. Surgical Dressings and Wound Management. Medetec, Cardiff; 2010.Urciuolo F, Casale C, Imparato G, Netti PA. Bioengineered skin substitutes: the role of extracellular matrix and vascularization in the healing of deep wounds. J Clin Med. 2019;8(12):2083. doi:10.3390/jcm8122083Chandler LA, Alvarez OM, Blume PA, et al. Wound conforming matrix containing purified homogenate of dermal collagen promotes healing of diabetic neuropathic foot ulcers: comparative analysis versus standard of care. Adv Wound Care (New Rochelle). 2020;9(2):61-67. doi:10.1089/wound.2019.1024Westby MJ, Dumville JC, Soares MO, Stubbs N, Norman G. Dressings and topical agents for treating pressure ulcers. Cochrane Database Syst Rev. 2017;6(6):CD011947. doi:10.1002/14651858. CD011947.pub2Matriz extracelularHeridasÚlceraExtremidades inferioresTécnica de cierre de heridasExtracellular matrixInjurieslowerExtremity ulcerwound closure techniquesProtocol-driven Therapy for Lower Extremity Ulcers: A Case Series Supporting the Use of Porcine Intestine Extracellular MatrixArtículos Científicoshttp://purl.org/coar/resource_type/c_2df8fbb1http://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionNINGUNAinfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2PublicationLICENSElicense.txtlicense.txttext/plain; charset=utf-84334https://repository.ucc.edu.co/bitstreams/c4d7cd09-4a29-48de-96b9-afed0f3745bd/download3bce4f7ab09dfc588f126e1e36e98a45MD5120.500.12494/49052oai:repository.ucc.edu.co:20.500.12494/490522024-08-10 22:49:47.387metadata.onlyhttps://repository.ucc.edu.coRepositorio Institucional Universidad Cooperativa de 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