Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Dermatol Surg. 2010 Apr;36(4):453-60. doi: 10.1111/j.1524-4725.2010.01480.x. Epub 2010 Feb 19.
There is no ideal procedure for the treatment of chronic skin ulcers. The use of platelet gel (PG) in this indication is raising interest.
To evaluate the safety and efficacy of a new procedure combining allogeneic single-donor PG and fibrin glue (FG) to enhance skin graft take for treating recalcitrant ulcers.
MATERIALS & METHODS: Fifteen patients with 17 ulcers of various etiologies were enrolled. Skin ulcers were débrided, and the wounds covered with moist saline dressing. Three to 14 days later, the wound bed was sprayed with PG, a thin split-thickness skin graft with multiple slits was put on the wound bed, and FG was sprayed on the skin graft. A short leg polypropylene splint was used to immobilize the skin graft.
Most skin grafts took well. The interval between skin graft and complete wound healing ranged from 3 weeks to 2 months. No recurrence of ulcers was noted during the 3- to 18-month follow-up period. No adverse reactions were observed.
The procedure provides advantages in skin grafting for recalcitrant ulcers because PG functions as a delivery system of powerful mitogenic and chemostatic factors and FG as a hemostatic tissue sealant that avoids the use of staples or sutures.
目前慢性皮肤溃疡尚无理想的治疗方法。人们对使用血小板凝胶（PG）治疗该疾病的兴趣日益浓厚。
评估联合应用同种异体供者 PG 和纤维蛋白胶（FG）增强皮肤移植物成活率，以治疗顽固型溃疡的新方法的安全性和有效性。
共纳入 15 例 17 处不同病因的皮肤溃疡患者。皮肤溃疡清创后，用生理盐水湿敷料覆盖创面。3 至 14 天后，创面喷涂 PG，在创面铺上多层薄的、带多个切口的刃厚皮片，然后喷涂 FG。用短腿聚丙烯夹板固定皮片。
多数皮片均顺利成活。皮肤移植与完全愈合的时间间隔为 3 周至 2 个月。3 至 18 个月的随访期间，溃疡无复发。未观察到不良反应。
该方法在治疗顽固型溃疡的皮肤移植方面具有优势，因为 PG 可作为具有强大有丝分裂和止血作用的因子的递送系统，FG 可作为止血组织密封剂，避免使用订书钉或缝线。
