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通过富血小板血浆减轻分层皮片供区疼痛:一系列配对研究。

Reduction of pain via platelet-rich plasma in split-thickness skin graft donor sites: a series of matched pairs.

作者信息

Miller John D, Rankin Timothy M, Hua Natalie T, Ontiveros Tina, Giovinco Nicholas A, Mills Joseph L, Armstrong David G

机构信息

Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, University of Arizona College of Medicine, Tucson, AZ, USA.

Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, University of Arizona College of Medicine, Tucson, AZ, USA;

出版信息

Diabet Foot Ankle. 2015 Jan 22;6:24972. doi: 10.3402/dfa.v6.24972. eCollection 2015.

Abstract

In the past decade, autologous platelet-rich plasma (PRP) therapy has seen increasingly widespread integration into medical specialties. PRP application is known to accelerate wound epithelialization rates, and may also reduce postoperative wound site pain. Recently, we observed an increase in patient satisfaction following PRP gel (Angel, Cytomedix, Rockville, MD) application to split-thickness skin graft (STSG) donor sites. We assessed all patients known to our university-based hospital service who underwent multiple STSGs up to the year 2014, with at least one treated with topical PRP. Based on these criteria, five patients aged 48.4±17.6 (80% male) were identified who could serve as their own control, with mean time of 4.4±5.1 years between operations. In both therapies, initial dressing changes occurred on postoperative day (POD) 7, with donor site pain measured by Likert visual pain scale. Paired t-tests compared the size and thickness of harvested skin graft and patient pain level, and STSG thickness and surface area were comparable between control and PRP interventions (p>0.05 for all). Donor site pain was reduced from an average of 7.2 (±2.6) to 3 (±3.7), an average reduction in pain of 4.2 (standard error 1.1, p=0.0098) following PRP use. Based on these results, the authors suggest PRP as a beneficial adjunct for reducing donor site pain following STSG harvest.

摘要

在过去十年中,自体富血小板血浆(PRP)疗法在医学专科中的应用越来越广泛。已知PRP的应用可加快伤口上皮化速度,还可能减轻术后伤口部位的疼痛。最近,我们观察到在将PRP凝胶(Angel,Cytomedix,马里兰州罗克维尔)应用于中厚皮片(STSG)供皮区后,患者满意度有所提高。我们评估了截至2014年在我们大学附属医院接受多次STSG手术且至少有一次接受局部PRP治疗的所有患者。根据这些标准,确定了五名年龄为48.4±17.6岁(80%为男性)的患者,他们可以作为自身对照,两次手术之间的平均时间为4.4±5.1年。在两种治疗方法中,均在术后第7天(POD)进行首次换药,采用Likert视觉疼痛量表测量供皮区疼痛。配对t检验比较了所取皮片的大小和厚度以及患者的疼痛程度,对照干预和PRP干预之间的STSG厚度和表面积具有可比性(所有p>0.05)。使用PRP后,供皮区疼痛从平均7.2(±2.6)降至3(±3.7),平均疼痛减轻4.2(标准误1.1,p=0.0098)。基于这些结果,作者建议PRP作为减少STSG取皮后供皮区疼痛的有益辅助手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0792/4306752/cd820286ac50/DFA-6-24972-g001.jpg

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