Marck Roos E, Gardien Kim L M, Stekelenburg Carlijn M, Vehmeijer Marielle, Baas D, Tuinebreijer Wim E, Breederveld Roelf S, Middelkoop Esther
Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center Amsterdam, The Netherlands.
Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.
Wound Repair Regen. 2016 Jul;24(4):712-20. doi: 10.1111/wrr.12443. Epub 2016 Jun 3.
Platelet-rich plasma (PRP) is a fraction of blood with a platelet concentration above baseline. When platelets get activated, growth factors involved in wound healing are released. The application of PRP has shown good results in wound care, however, up to date no substantial research has been performed on the effect of PRP in burn treatment. This randomized double blind intra-patient controlled study investigates the effect of autologous PRP on wound healing in burns that require surgery with a meshed split skin graft (SSG). Fifty-two patients with various areas of deep dermal to full thickness burns, receiving surgery with a SSG were included after informed consent. Comparable study areas A and B (intra-patient) were appointed, randomized and either treated with a SSG and PRP or with a SSG alone. At day 5 to 7 postoperative, the epithelialization and graft take rate were assessed. Three, six, and twelve months postoperative, follow-up measurements were performed in the form of POSAS-questionnaires, DermoSpectroMeter, and Cutometer measurements. There was no statistically significant difference between the mean take rate nor the mean epithelialization rate at day 5-7 between the PRP-treated and control areas. However, PRP-treated wound areas showed more often better or equal epithelialization and take rates at day 5-7 than the standard treated areas. Minor effects were also seen in the reoperated and early operated subgroups. At 3, 6, and 12 months postoperative, POSAS scores from the patients and the observers, Dermaspectro-, and Cutometer measurements did not depict a significant difference between the PRP and standard treated areas. Concluding, the addition of PRP in the treatment of burn wounds did not result in improved graft take and epithelialization, nor could we demonstrate better scar quality. There was, however, a considerable variation in our clinical population.
富血小板血浆(PRP)是血液中血小板浓度高于基线的部分。当血小板被激活时,会释放参与伤口愈合的生长因子。PRP的应用在伤口护理方面已显示出良好效果,然而,迄今为止尚未对PRP在烧伤治疗中的作用进行实质性研究。这项随机双盲患者自身对照研究调查了自体PRP对需要进行网状自体断层皮片移植(SSG)手术的烧伤伤口愈合的影响。在获得知情同意后,纳入了52例不同面积深二度至全层烧伤且接受SSG手术的患者。指定、随机分配了具有可比性的研究区域A和B(患者自身对照),分别用SSG加PRP或仅用SSG进行治疗。术后第5至7天,评估上皮化和植皮成活率。术后3个月、6个月和12个月,通过POSAS问卷、皮肤光谱仪和皮肤弹性测量仪进行随访测量。在第5 - 7天,PRP治疗区域和对照区域之间的平均植皮成活率和平均上皮化率没有统计学上的显著差异。然而,在第5 - 7天,PRP治疗的伤口区域比标准治疗区域更常出现更好或相同的上皮化和植皮成活率。在再次手术和早期手术的亚组中也观察到了轻微效果。术后3个月、6个月和12个月,患者和观察者的POSAS评分、皮肤光谱仪和皮肤弹性测量仪测量结果显示PRP治疗区域和标准治疗区域之间没有显著差异。结论是,在烧伤创面治疗中添加PRP并未提高植皮成活率和上皮化程度,我们也未能证明瘢痕质量更好。然而,我们的临床人群存在相当大的差异。
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