First Department of General and Vascular Surgery, Second Faculty of Medicine, Warsaw Medical University, Warsaw, Poland.
Department of Orthopedics and Rehabilitation, Warsaw Medical University, Warsaw, Poland.
Adv Exp Med Biol. 2019;1176:109-117. doi: 10.1007/5584_2019_388.
The study investigated whether the application of dressings with autologous platelet-rich plasma (PRP) would reduce the healing time in patients with chronic venous leg ulcers. This is a prospective observational study that included 100 patients diagnosed with lower extremity venous insufficiency complicated by ulceration of a leg or foot, who had been after angioplasty of stenotic artery. Patients were divided into two groups of 50 each: treated with PRP (study group) and treated with conventional hydrocolloid dressings (control group). We followed the wound changes at Day 10, Day 20, and Day 30 of treatment and compared them with the baseline appearance at Day 0. We evaluated the appearance, area, and depths of wounds with ultrasound. The granulation process was examined histologically to document skin formation and wound tissue neovascularization. The findings were that treatment with PRP dressings resulted in a significant progressive reduction in ulcer size, irrespective of the ulcer's initial size, compared to treatment with conventional dressings. Further, the best effect of PRP was noticed in the category of largest wounds. After a month of treatment with PRP dressings, more than 50% of all ulcers were completely healed. The young epidermis appeared together with the granulation tissue, and the formation of dermis took shape after 20 days of treatment. We conclude that the use of PRP dressings is a safe, nonsurgical adjunctive procedure for treating chronic venous leg ulcers. The potential benefit of PRP dressings over conventional ulcer treatment requires further in-depth exploration.
本研究旨在探讨富含自体血小板的敷贴（PRP）的应用是否会缩短慢性静脉性腿部溃疡患者的愈合时间。这是一项前瞻性观察性研究，纳入了 100 例经血管成形术治疗狭窄性动脉后下肢静脉功能不全合并腿部或足部溃疡的患者。患者分为两组，每组 50 例：一组用 PRP（研究组）治疗，另一组用常规水胶体敷贴（对照组）治疗。我们在治疗第 10 天、第 20 天和第 30 天观察伤口变化，并与第 0 天的基线外观进行比较。我们用超声评估伤口的外观、面积和深度。通过组织学检查肉芽组织，记录皮肤形成和伤口组织新生血管形成。结果表明，与常规敷贴治疗相比，PRP 敷贴治疗可显著减少溃疡面积，而与溃疡的初始大小无关。此外，PRP 的最佳效果在最大面积的溃疡中表现最为明显。在 PRP 敷贴治疗一个月后，超过 50%的所有溃疡完全愈合。新生表皮与肉芽组织一起出现，经过 20 天的治疗，真皮形成。我们得出结论，PRP 敷贴是治疗慢性静脉性腿部溃疡的一种安全、非手术的辅助治疗方法。PRP 敷贴相对于常规溃疡治疗的潜在益处需要进一步深入探讨。
