Volakakis Evangelos, Papadakis Marios, Manios Andreas, Ioannou Christos V, Zoras Odysseas, de Bree Eelco
Department of Surgical Oncology, Medical School of Crete University Hospital, Heraklion, Greece; Intensive Care Unit, Venizeleio Hospital, Heraklion, Greece; Medical School, University of Crete, Heraklion, Greece.
Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, Helios University Hospital Wuppertal-University of Witten/Herdecke, Wuppertal, Germany.
Wounds. 2019 Oct;31(10):252-256. Epub 2019 Jul 31.
The effectiveness of autologous platelet-rich plasma (PRP) in chronic wounds remains controversial.
The aim of this prospective study is to objectively assess the impact of PRP therapy on pressure ulcer (PU) healing utilizing digital planimetry.
Eligible patients included those with PUs with a surface area ⟩ 1 cm2 and ⟩ 3 months' duration. Each ulcer initially was debrided surgically. The patient then was advised to continue conventional treatment for 4 weeks, after which time repeat debridement was performed as needed. Subsequently, PRP was applied and the patient was observed for an additional 4 weeks. During the 8-week study period, the treatment's effectiveness was assessed weekly with digital planimetry. The Wilcoxon signed-rank test was used to compare continuous variables.
Thirty-six patients (22 men, 14 women) with a median age of 62 years (range, 38-88 years), who had 64 PUs with an initial median surface area of 20 cm2 (range, 1 cm2-180 cm2), a median diameter of 6.3 cm (range, 1.3 cm-18.6 cm), and a median circumference of 16.8 cm (range, 4 cm-68 cm) were included. Reduction of median surface area (63% vs. 41%), median maximal diameter (33% vs. 20%), and median circumference (38% vs. 21%) were significantly (P ⟨ .001) greater after PRP treatment compared with after conventional treatment.
It appears treatment with PRP accelerates healing of PUs as objectively measured by digital planimetry. Compared with conventional treatment, a significantly higher reduction in surface area, diameter, and circumference of PUs was observed following application of PRP.
富自体血小板血浆(PRP)在慢性伤口治疗中的有效性仍存在争议。
本前瞻性研究旨在利用数字平面测量法客观评估PRP疗法对压疮(PU)愈合的影响。
符合条件的患者包括患有表面积>1 cm²且病程>3个月的压疮患者。每个溃疡最初均进行手术清创。然后建议患者继续进行4周的常规治疗,之后根据需要进行重复清创。随后,应用PRP并对患者额外观察4周。在为期8周的研究期间,每周使用数字平面测量法评估治疗效果。采用Wilcoxon符号秩检验比较连续变量。
纳入36例患者(22例男性,14例女性),中位年龄62岁(范围38 - 88岁),他们共有64处压疮,初始中位表面积为20 cm²(范围1 cm² - 180 cm²),中位直径为6.3 cm(范围1.3 cm - 18.6 cm),中位周长为16.8 cm(范围4 cm - 68 cm)。与常规治疗后相比,PRP治疗后中位表面积减少(63%对41%)、中位最大直径减少(33%对20%)和中位周长减少(38%对21%)均显著更大(P<0.001)。
数字平面测量法客观测量显示,PRP治疗似乎可加速压疮愈合。与常规治疗相比,应用PRP后观察到压疮的表面积、直径和周长减少幅度显著更高。