Oliveira Mariele Gobo de, Abbade Luciana Patricia Fernandes, Miot Hélio Amante, Ferreira Rosana Rossi, Deffune Elenice
Department of Nursing, Botucatu Medical School - São Paulo State University "Júlio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil.
Department of Dermatology and Radiotherapy, Botucatu Medical School - São Paulo State University "Júlio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil.
An Bras Dermatol. 2017 Jul-Aug;92(4):499-504. doi: 10.1590/abd1806-4841.20175496.
BACKGROUND:: Venous ulcers represent 70% of the lower limb ulcers. They are difficult to heal, requiring a correct diagnostic and therapeutic approach. Many products have been developed to healing, such as homologous platelet gel obtained from the platelet concentrate exceeding from blood transfusion. OBJECTIVE:: To evaluate the safety and efficacy of homologous platelet gel in venous ulcers compared with hydrocolloid dressing. METHOD:: A pilot randomized clinical trial in patients with venous ulcers. Randomized groups (homologous platelet gel and hydrocolloid groups) were followed for 90 days and were assessed through the evolution of ulcerated area, qualitative analysis of vascularization and adverse events. Both groups used elastic compression. RESULTS:: We included 16 participants, with a total of 21 venous ulcers. Both treatments promoted a reduction of the areas of the ulcers in 90 days (mean 69%), there was significant difference between the groups concerning the gradual reduction of the ulcers areas, favorably to the hydrocolloid (70% vs 64%; p <0.01). There were some mild adverse events in both groups. STUDY LIMITATIONS:: Single-center study with a small number of patients, preventing more accurate assessment of the effects of platelet gel. CONCLUSION:: The homologous platelet gel associated with the elastic compression can be an alternative to the venous ulcer treatment and is safe due to the occurrence of a few mild local adverse events and no serious adverse events. Clinical trials with larger numbers of patients must be performed to maintain the indication of this treatment for venous ulcer.
背景:静脉性溃疡占下肢溃疡的70%。它们难以愈合,需要正确的诊断和治疗方法。已经开发了许多用于愈合的产品,例如从输血剩余的血小板浓缩物中获得的同源血小板凝胶。 目的:评估与水胶体敷料相比,同源血小板凝胶治疗静脉性溃疡的安全性和有效性。 方法:对静脉性溃疡患者进行一项初步随机临床试验。随机分组(同源血小板凝胶组和水胶体组)随访90天,并通过溃疡面积的变化、血管化定性分析和不良事件进行评估。两组均使用弹力袜。 结果:我们纳入了16名参与者,共有21个静脉性溃疡。两种治疗方法均使溃疡面积在90天内缩小(平均69%),两组之间溃疡面积的逐渐缩小存在显著差异,水胶体组更有利(70%对64%;p<0.01)。两组均有一些轻度不良事件。 研究局限性:单中心、小样本研究,妨碍了对血小板凝胶效果更准确的评估。 结论:同源血小板凝胶联合弹力袜可作为静脉性溃疡治疗的一种选择,由于仅发生少数轻度局部不良事件且无严重不良事件,因此是安全的。必须进行更大规模患者的临床试验,以维持这种治疗方法对静脉性溃疡的适应证。
An Bras Dermatol. 2017
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