a Graduate School of Periodontics and Implant Dentistry , University of the Andes (UANDES) , Santiago , Chile.
b Department of Oral Health Sciences, Katholieke Universiteit Leuven (KUL) & Periodontology , University Hospitals Leuven , Leuven , Belgium.
Platelets. 2018 Jul;29(5):468-475. doi: 10.1080/09537104.2017.1327654. Epub 2017 Jul 20.
Chronic wounds (VLU: venous leg ulcer, DFU: diabetic foot ulcer, PU: pressure ulcer, or complex wounds) affect a significant proportion of the population. Despite appropriate standard wound care, such ulcers unfortunately may remain open for months or even years. The use of leukocyte- and platelet-rich fibrin (L-PRF) to cure skin ulcers is a simple and inexpensive method, widely used in some countries but unknown or neglected in most others. This auto-controlled prospective cohort study explored and quantified accurately for the first time the adjunctive benefits of topical applications of L-PRF in the management of such refractory ulcers in a diverse group of patients. Forty-four consecutive patients with VLUs (n = 28, 32 wounds: 17 ≤ 10 cm and 15 > 10 cm), DPUs (n = 9, 10 wounds), PUs (n = 5), or complex wounds (n = 2), all refractory to standard treatment for ≥3 months, received a weekly application of L-PRF membranes. L-PRF was prepared following the original L-PRF method developed more than 15 years ago (400g, 12 minutes) using the Intra-Spin L-PRF centrifuge/system and the XPression box kit (Intra-Lock, Boca Raton, FL, USA; the only CE/FDA cleared system for the preparation of L-PRF). Changes in wound area were recorded longitudinally via digital planimetry. Adverse events and pain levels were also registered. All wounds showed significant improvements after the L-PRF therapy. All VLUs ≤ 10 cm, all DFUs, as well as the two complex wounds showed full closure within a 3-month period. All wounds of patients with VLUs > 10 cm who continued therapy (10 wounds) could be closed, whereas in the five patients who discontinued therapy improvement of wound size was observed. Two out of the five PUs were closed, with improvement in the remaining three patients who again interrupted therapy (surface evolution from 7.35 ± 4.31 cm to 5.78 ± 3.81 cm). No adverse events were observed. A topical application of L-PRF on chronic ulcers, recalcitrant to standard wound care, promotes healing and wound closure in all patients following the treatment. This new therapy is simple, safe and inexpensive, and should be considered a relevant therapeutic option for all refractory skin ulcers.
慢性创面（VLU：静脉性腿部溃疡，DFU：糖尿病足溃疡，PU：压力性溃疡，或复杂创面）影响了相当大比例的人群。尽管采用了适当的标准伤口护理，但这些溃疡不幸地可能会持续数月甚至数年不愈合。使用富含白细胞和血小板的纤维蛋白（L-PRF）来治疗皮肤溃疡是一种简单且廉价的方法，在一些国家得到广泛应用，但在大多数其他国家尚不知道或被忽视。这项自体对照前瞻性队列研究首次准确地探索和量化了在一组不同的患者中，局部应用 L-PRF 辅助治疗这些难治性溃疡的附加益处。44 例连续的 VLU 患者（n=28，32 个创面：17 个创面大于等于 10cm，15 个创面大于 10cm）、DFU 患者（n=9，10 个创面）、PU 患者（n=5）或复杂创面患者（n=2），所有患者的创面均对标准治疗≥3 个月无反应，每周接受一次 L-PRF 膜治疗。L-PRF 是按照 15 年前开发的原始 L-PRF 方法（400g，12 分钟）制备的，使用 Intra-Spin L-PRF 离心机/系统和 XPression 盒试剂盒（Intra-Lock，Boca Raton，FL，USA；这是唯一获得 CE/FDA 批准用于制备 L-PRF 的系统）。通过数字描绘法纵向记录创面面积的变化。还记录了不良反应和疼痛程度。所有创面在 L-PRF 治疗后均显示出显著改善。所有 VLU 小于等于 10cm，所有 DFU 以及两个复杂创面在 3 个月内完全闭合。继续治疗的 10 个 VLU 大于 10cm 的创面均能闭合，而 5 个停止治疗的患者创面大小有所改善。5 个 PU 中有 2 个闭合，其余 3 个患者因再次中断治疗而创面改善（从 7.35±4.31cm 到 5.78±3.81cm）。未观察到不良反应。在标准伤口护理无效的慢性溃疡上局部应用 L-PRF 可促进所有患者的愈合和创面闭合。这种新疗法简单、安全且廉价，应被视为所有难治性皮肤溃疡的一种有意义的治疗选择。
