Baylor Specialty Hospital, Dallas, Texas, USA.
Adv Skin Wound Care. 2011 Aug;24(8):357-68. doi: 10.1097/01.ASW.0000403249.85131.6f.
This study investigated clinical outcomes in chronic nonhealing wounds following the short-term use of an enhanced, near-physiological concentration of platelet-rich plasma (PRP) gel (AutoloGel System, Cytomedix, Inc, Gaithersburg, Maryland).
Study design was a large, observational case series using a multicenter registry database (all wounds included), which compared different populations within the database.
Thirty-nine centers contributed to the registry, including long-term acute-care centers, outpatient clinics, a durable medical equipment company, a home health agency, and a long-term-care center.
The target population included 285 chronic wounds (patient n = 200). Wound etiologies included diabetic, pressure, or venous ulcer; dehisced, surgical, or traumatic wound; and wounds of other etiologies.
Therapeutic, PRP gel is produced from patient blood utilizing autologous platelets and plasma that contribute growth factors, cytokines, and chemokines, in a fibrin matrix.
Area and volume of the wound and the linear total of undermining and sinus tracts/tunneling were calculated. Clinical relevance was determined by analyzing outcomes in wounds that responded to treatment.
A positive response occurred in 96.5% of wounds within 2.2 weeks with 2.8 treatments. In 86.3% of wounds, 47.5% area reduction occurred, and 90.5% of wounds had a 63.6% volume reduction. In 89.4% undermined and 85.7% of sinus tracts/tunneling wounds, 71.9% and 49.3% reductions in linear total were observed, respectively.
In chronic wounds recalcitrant to other treatments, utilization of PRP gel can restart the healing process. Rapid treatment response was observed in 275 of 285 wounds, and the magnitude of response was consistently high, with statistically significant outcomes reported for various subgroups.
本研究调查了短期使用富含血小板的血浆(PRP)凝胶(AutoloGel System,Cytomedix,Inc.,马里兰州盖瑟斯堡)后慢性非愈合性伤口的临床结果。
研究设计为使用多中心注册数据库(包括所有伤口)的大型观察性病例系列,该数据库比较了数据库内的不同人群。
39 个中心参与了该注册中心,包括长期急性护理中心、门诊诊所、耐用医疗设备公司、家庭保健机构和长期护理中心。
目标人群包括 285 例慢性伤口(患者 n=200)。伤口病因包括糖尿病、压力或静脉溃疡;裂开、手术或创伤性伤口;以及其他病因的伤口。
治疗性 PRP 凝胶是从患者血液中利用自体血小板和血浆产生的,其中包含生长因子、细胞因子和趋化因子,形成纤维蛋白基质。
计算伤口的面积和体积以及潜行和窦道/隧道的线性总长度。通过分析对治疗有反应的伤口的结果来确定临床相关性。
在 2.2 周内接受 2.8 次治疗后,96.5%的伤口出现阳性反应。在 86.3%的伤口中,面积减少了 47.5%,90.5%的伤口体积减少了 63.6%。在 89.4%的潜行和 85.7%的窦道/隧道伤口中,观察到线性总长度分别减少了 71.9%和 49.3%。
在对其他治疗方法有抵抗力的慢性伤口中,使用 PRP 凝胶可以重新启动愈合过程。在 275 例 285 例伤口中观察到快速治疗反应,反应幅度始终很高,对各种亚组报告了具有统计学意义的结果。