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富血小板血浆治疗清洁型糖尿病足溃疡

Platelet-Rich Plasma for the Treatment of Clean Diabetic Foot Ulcers.

作者信息

Ahmed Marwa, Reffat Sherif A, Hassan Amany, Eskander Fikry

机构信息

Department of Clinical Pathology, Suez Canal University, Ismailia, Egypt.

Department of Surgery, Suez Canal University, Ismailia, Egypt.

出版信息

Ann Vasc Surg. 2017 Jan;38:206-211. doi: 10.1016/j.avsg.2016.04.023. Epub 2016 Aug 12.

Abstract

BACKGROUND

Diabetic foot ulcer is considered as a major health problem that predisposes to limb amputation. Among the different methods to achieve ulcer healing, platelet-rich plasma (PRP) gel is gaining popularity. It is thought to stimulate wound closure by providing essential growth factors for healing. This study aims to evaluate the value of autologous PRP gel in the treatment of diabetic ulcers.

METHODS

The study included 56 patients of both sex from 18 to 80 years, with clean chronic diabetic foot ulcers divided into 2 equal groups. The first group was treated by antiseptic ointment dressing, and the second group was treated by autologous platelet gel. PRP together with thrombin were prepared by centrifugation at each dressing session. Thrombin and calcium chloride were used to activate the PRP. The formed platelet gel was applied to the wound twice weekly.

RESULTS

Statically significant increase in healing rate was found in the PRP-treated group, and complete healing was achieved in 86% of them in comparison to 68% of the control group. In the study group, rate of healing per week was greater during the first 8 weeks and starts to decline afterward. The use of platelet gel showed a lower rate of wound infection.

CONCLUSIONS

Autologous platelet gel is more effective than the local antiseptic dressing in terms of healing rate and prevention of infection in clean diabetic ulcers.

摘要

背景

糖尿病足溃疡被认为是导致肢体截肢的主要健康问题。在实现溃疡愈合的不同方法中,富血小板血浆(PRP)凝胶越来越受欢迎。人们认为它通过提供促进愈合的重要生长因子来刺激伤口闭合。本研究旨在评估自体PRP凝胶在治疗糖尿病溃疡中的价值。

方法

该研究纳入了56例年龄在18至80岁之间的男女患者,他们患有清洁的慢性糖尿病足溃疡,被分为两组,每组人数相等。第一组采用抗菌药膏敷料治疗,第二组采用自体血小板凝胶治疗。每次换药时通过离心制备PRP和凝血酶。使用凝血酶和氯化钙激活PRP。形成的血小板凝胶每周两次应用于伤口。

结果

PRP治疗组的愈合率有统计学意义的显著提高,其中86%实现了完全愈合,而对照组为68%。在研究组中,前8周每周的愈合率更高,之后开始下降。使用血小板凝胶显示伤口感染率较低。

结论

就清洁糖尿病溃疡的愈合率和预防感染而言,自体血小板凝胶比局部抗菌敷料更有效。

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