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脂肪移植和富血小板血浆治疗创面愈合疗效的系统评价

Systematic review of the efficacy of fat grafting and platelet-rich plasma for wound healing.

机构信息

London Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.

Division of Surgery and Interventional Science, University College London, London, UK.

出版信息

Int Wound J. 2018 Aug;15(4):519-526. doi: 10.1111/iwj.12892. Epub 2018 May 9.

Abstract

Adipose-derived stem cells found in fat grafts may have significant healing properties. When fat is combined with autologous platelet-rich plasma (PRP), there may be enhanced healing effects due to the pro-angiogenic and anti-inflammatory effects of PRP. This study aimed to evaluate the current evidence on fat grafting in combination with PRP for wound healing to establish the efficacy of this technique. A comprehensive search in the MEDLINE, EMBASE, CENTRAL, Science Citation Index, and Google Scholar databases (to March 2017) was conducted to identify studies on fat grafting and PRP for wound healing. Case series of less than 3 cases and studies only describing harvest technique were excluded. The database identified 571 articles, of which 3 articles that used a combination of fat and PRP for wound healing (1 RCT and 2 case series) were included in this review. A total of 69 wounds in 64 patients were treated with an average wound size of 36.32cm . Of these, 67% of wounds achieved complete healing. When reported, the mean time to healing was 7.5 weeks for those who underwent a single treatment. There were no significant complications in any patients. The combination of fat grafting and PRP may achieve adequate wound healing with relatively quick wound healing time compared with standard wound management options. However, evidence is extremely limited, and further studies are required to evaluate its efficacy for wound healing.

摘要

脂肪移植中发现的脂肪来源干细胞可能具有显著的愈合特性。当脂肪与自体富血小板血浆 (PRP) 结合时,由于 PRP 的促血管生成和抗炎作用,可能会产生增强的愈合效果。本研究旨在评估脂肪移植联合 PRP 治疗创伤愈合的现有证据,以确定该技术的疗效。在 MEDLINE、EMBASE、CENTRAL、科学引文索引和 Google Scholar 数据库(截至 2017 年 3 月)中进行了全面检索,以确定有关脂肪移植和 PRP 治疗创伤愈合的研究。排除了少于 3 例的病例系列和仅描述采集技术的研究。数据库共确定了 571 篇文章,其中有 3 篇文章将脂肪和 PRP 联合用于创伤愈合(1 项 RCT 和 2 项病例系列),被纳入本综述。共有 64 名患者的 69 个伤口接受了治疗,平均伤口大小为 36.32cm。其中,67%的伤口完全愈合。报告显示,单次治疗的平均愈合时间为 7.5 周。所有患者均无明显并发症。与标准的伤口管理方法相比,脂肪移植和 PRP 的联合应用可能实现足够的伤口愈合,且伤口愈合时间相对较快。然而,证据极其有限,需要进一步的研究来评估其对创伤愈合的疗效。

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