Kim Haena, Gallo Julio
Department of Otolaryngology-Head and Neck Surgery, University of Miami, Miami, Florida.
The Miami Institute for Age Management and Intervention, Miami, Florida.
JAMA Facial Plast Surg. 2015 Mar-Apr;17(2):97-102. doi: 10.1001/jamafacial.2014.1085.
Despite the advantages and reduced recovery time of ablative fractional photothermolysis, patients still seek adjuvant treatments to reduce healing time and facilitate their return to normal social and work activity. Platelet-rich plasma (PRP) has been used for many applications in various surgical fields for its ability to improve wound healing, hemostasis, and graft survival.
To determine whether PRP will be an effective adjunctive treatment to fractional carbon dioxide resurfacing and reduce healing time and duration of adverse effects.
DESIGN, SETTING, AND PARTICIPANTS: Prospective blinded study of male and female patients 18 years or older and with Fitzpatrick skin types I to IV performed at Miami Institute for Age Management and Intervention.
Using a fractional carbon dioxide laser (60 mJ at 150 Hz), a 1-cm2 area was treated on each forearm of every patient. Immediately after the laser treatment, patients were randomized to receive PRP in the right or left forearm and saline in the other forearm. Pictures of each forearm were taken immediately after injection of PRP and then on a daily basis until reepithelialization (eschar formation) occurred.
Posttreatment erythema, edema, and reepithelialization.
Significant improvement in posttreatment erythema was observed in PRP-treated arms across 94 comparisons in 15 patients. Improvement was defined as the erythema rating of the untreated arm minus the erythema rating of the PRP-treated arm. The mean (standard error of the mean) improvement in grade was 0.26 (0.092; t statistic, 2.83; P = .003). A mean (standard error of the mean) improvement in edema grade of 0.13 (0.059) was also significant across 94 comparisons (t statistic, 2.20; P = .02). Our preliminary results suggest that PRP can objectively reduce erythema and edema following carbon dioxide fractional laser treatment. Most importantly, patients themselves have noticed a reduction in the common posttreatment effects: erythema, edema, pruritus, and discomfort.
We anticipate that PRP can be an efficacious adjunctive treatment to carbon dioxide laser resurfacing and can aid patients in hastening their return to their normal routine.
尽管剥脱性点阵光热解有诸多优点且恢复时间缩短，但患者仍寻求辅助治疗以缩短愈合时间并促进其恢复正常社交和工作活动。富血小板血浆（PRP）因其能改善伤口愈合、止血和移植物存活，已在多个外科领域有多种应用。
确定PRP是否为二氧化碳点阵磨皮术的有效辅助治疗方法，并缩短愈合时间和不良反应持续时间。
设计、设置和参与者：在迈阿密年龄管理与干预研究所对18岁及以上、Fitzpatrick皮肤分型为I至IV型的男性和女性患者进行前瞻性双盲研究。
使用二氧化碳点阵激光（150赫兹时60毫焦），对每位患者的每只前臂上1平方厘米的区域进行治疗。激光治疗后立即将患者随机分组，使其一只前臂接受PRP注射，另一只前臂接受生理盐水注射。在注射PRP后立即拍摄每只前臂的照片，然后每天拍摄，直至上皮再形成（焦痂形成）。
治疗后红斑、水肿和上皮再形成情况。
在15名患者的94次比较中，PRP治疗组的前臂治疗后红斑有显著改善。改善定义为未治疗组前臂的红斑评分减去PRP治疗组前臂的红斑评分。红斑分级的平均（平均标准误）改善为0.26（0.092；t统计量，2.83；P = 0.003）。在94次比较中，水肿分级的平均（平均标准误）改善为0.13（0.059）也具有显著性（t统计量，2.20；P = 0.02）。我们的初步结果表明，PRP可客观减轻二氧化碳点阵激光治疗后的红斑和水肿。最重要的是，患者自身已注意到常见治疗后效应（红斑、水肿、瘙痒和不适）有所减轻。
我们预计PRP可为二氧化碳激光磨皮术的有效辅助治疗方法，并有助于患者更快恢复正常生活。
1级。
