title: Hard to heal pressure ulcers (stage III-IV): efficacy of injected activated macrophage suspension (AMS) as compared with standard of care (SOC) treatment controlled trial.
abstract: The objective of this study was to compare local injections of AMS with SOC treatments for stage III and IV pressure ulcers in elderly patients. It was designed as historically prospective 2-arms non-parallel open controlled trial, and conducted in a department of geriatric medicine and rehabilitation of a university affiliated tertiary hospital. We studied 100 consecutive elderly patients with a total of 216 stage III or IV pressure ulcers, 66 patients were assigned to the AMS group and had their wounds injected, while 38 patients were assigned to the SOC group. Primary outcome was rate of complete wound closure. Time to complete wound closure and 1-year mortality served as secondary outcomes. Statistical analyses were performed at both patient and wound levels. Percentage of completely closed wounds (wound level and patient level) were significantly better (p<0.001/p<0.001, respectively) in all patients in favor of AMS, as well as in the subset of diabetic patients (p<0.001/p<0.001). Similarly, AMS proved significantly better for the subset of those with leg ulcers and with baseline wounds ≤15 cm(2), compared with SOC. There were no statistically significant differences with regard to time to complete closure or 1-year mortality rates in the two groups. It is concluded that there is a significant difference in favor of stage III and IV wound closure rates by AMS, as compared with SOC treatments.
authors.affiliation: Research and Development Unit, Magen David Adom National Blood Services, Tel-Hashomer 52621, Ramat-Gan, Israel. adi_zs@netvision.net.il
authors.forename: Adi
authors.initials: A
authors.lastname: Zuloff-Shani
authors.forename: Abraham
authors.initials: A
authors.lastname: Adunsky
authors.forename: Aviva
authors.initials: A
authors.lastname: Even-Zahav
authors.forename: Haim
authors.initials: H
authors.lastname: Semo
authors.forename: Arie
authors.initials: A
authors.lastname: Orenstein
authors.forename: Jeremy
authors.initials: J
authors.lastname: Tamir
authors.forename: Eli
authors.initials: E
authors.lastname: Regev
authors.forename: Eilat
authors.initials: E
authors.lastname: Shinar
authors.forename: David
authors.initials: D
authors.lastname: Danon
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008264:Macrophages; D008297:Male; D003668:Pressure Ulcer / Q000628:therapy*; D011446:Prospective Studies; D013535:Suspensions; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D013535:Suspensions