Wang L, Liu G, Li Z, Jia B C, Wang Y
Department of Burns and Plastic Surgery, the 202nd Hospital of PLA, Shenyang 110003, China.
Zhonghua Shao Shang Za Zhi. 2018 Sep 20;34(9):637-642. doi: 10.3760/cma.j.issn.1009-2587.2018.09.014.
To investigate the clinical effect of platelet-rich fibrin (PRF) in the treatment of chronic wounds combined with subcutaneous stalking sinus caused by various kinds of reasons. The clinical data of 72 patients with chronic wounds and combined with subcutaneous stalking sinus caused by various kinds of reasons admitted to our unit from June 2015 to February 2017, conforming to the study criteria, were collected and retrospectively analyzed. Patients were divided into group PRF (=39) and routine dressing change (RDC) group (=33) according to their treatment. The subcutaneous stalking sinuses of patients in group PRF were filled with PRF 1 or 2 times after debridement, while the surface of wound was covered by vaseline gauze and aseptic dressing, and dressing change was performed once per 2-3 days. The wounds of patients in group RDC were filled with iodine gauze after debridement of wounds and wrapped up with conventional aseptic dressing, and dressing change was performed once per 0.5-2.0 days. The times of operation, the times of dressing change, the time for negative-conversing of bacteria culture in the secretion of wound, the time of subcutaneous stalking sinus closure, and the complete healing time of wounds of patients in two groups were recorded. Data were processed with Chi-square test and independent sample test. The operation times of patients in two groups were close (=0.565, >0.05). The dressing changes of patients in group PRF were (6.4±2.1) times, significantly less than (19.2±6.2) times in group RDC, =12.107, <0.01. The time for negative-conversing of bacteria culture in the secretion of wound of patients in group PRF was (15±5) d, significantly shorter than (25±9) d in group RDC, =6.087, <0.01. The time of subcutaneous stalking sinus closure of patients in group PRF was (12±5) d, significantly shorter than (24±8) d in group RDC, =7.315, <0.01. The complete healing time of wounds of patients in group PRF was (23±7) d, significantly shorter than (35±10) d in group RDC, =5.924, <0.01. All the chronic wounds of patients in two groups were completely healed, and there were no break or new sinus formed during the follow-up of 4-12 months after discharge. The application of PRF in the treatment of chronic wounds combined with subcutaneous stalking sinus caused by various reasons can bring about rapidly healing of wounds, definite effect, and convenient operation, thus is worth promoting and applying in clinic.
探讨富血小板纤维蛋白（PRF）治疗各种原因所致慢性创面合并皮下潜行窦道的临床效果。收集2015年6月至2017年2月我院收治的符合研究标准的72例各种原因所致慢性创面合并皮下潜行窦道患者的临床资料，并进行回顾性分析。根据治疗方法将患者分为PRF组（n = 39）和常规换药（RDC）组（n = 33）。PRF组患者清创后皮下潜行窦道内填充PRF 1或2次，创面表面覆盖凡士林纱布及无菌敷料，每2 - 3天换药1次。RDC组患者创面清创后用碘伏纱布填充，并用常规无菌敷料包扎，每0.5 - 2.0天换药1次。记录两组患者的手术次数、换药次数、创面分泌物细菌培养转阴时间、皮下潜行窦道闭合时间及创面完全愈合时间。数据采用卡方检验和独立样本t检验处理。两组患者手术次数相近（P = 0.565，P > 0.05）。PRF组患者换药次数为（6.4±2.1）次，明显少于RDC组的（19.2±6.2）次，P = 12.107，P < 0.01。PRF组患者创面分泌物细菌培养转阴时间为（15±5）天，明显短于RDC组的（25±9）天，P = 6.087，P < 0.01。PRF组患者皮下潜行窦道闭合时间为（12±5）天，明显短于RDC组的（24±8）天，P = 7.315，P < 0.01。PRF组患者创面完全愈合时间为（23±7）天，明显短于RDC组의（35±10）天，P = 5.924，P < 0.01。两组患者慢性创面均完全愈合，出院后4 - 12个月随访期间均无破溃或新窦道形成。PRF应用于治疗各种原因所致慢性创面合并皮下潜行窦道，可使创面迅速愈合，效果确切，操作简便，值得临床推广应用。
