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富血小板纤维蛋白对刃厚皮片供皮区创面愈合效果的评价:一项随机、安慰剂对照、三盲研究。

Evaluation of the Effect of Platelet-Rich Fibrin on Wound Healing at Split-Thickness Skin Graft Donor Sites: A Randomized, Placebo-Controlled, Triple-Blind Study.

机构信息

Sabzevar University of Medical Sciences, Sabzevar, Iran.

Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Int J Low Extrem Wounds. 2021 Mar;20(1):29-36. doi: 10.1177/1534734619900432. Epub 2020 Jan 30.

Abstract

Split-thickness skin grafting (STSG) is widely used to heal wounds resulting from trauma, burns, and chronic wounds. This study aimed to determine the true effect of platelet-rich fibrin (PRF) on patients with burn wounds requiring STSG during treatment of donor wounds. This randomized, triple-blind clinical trial was conducted on patients who referred to the burn ward of Vasei Hospital of Sabzevar, Iran, from May 2017 to May 2018. The donor site was randomly divided into 2 groups: PRF and control (Vaseline petrolatum gauze) using Vaseline gauze. In the intervention group, the PRF gel was applied to the wound and covered with Vaseline gauze and wet dressing. Conversely, only Vaseline gauze and wet dressing were applied to the control group. Outcome evaluation was conducted using paired test and Wilcoxon signed rank-sum test, as appropriate, on days 8 and 15. The mean age of the patients was 33.10 ± 2.60 years, and 51.50% were male. The mean wound healing time in the PRF and control groups was 11.80 ± 3.51 and 16.30 ± 4.32 days, respectively ( < .001). The PRF group showed significantly higher wound healing rates than the control group at 8 and 15 days dressing ( < .001 and < .001, respectively). Moreover, the mean wound healing for all wound healing indices diagnosed by 2 specialists in PRF was higher than control group on days 8 and 15 ( < .001). We found a statistically significant difference on days 8 and 15 regarding the mean pain levels between the 2 groups ( < .001). The findings showed that PRF can significantly increase the time and rate of donor wound healing compared with conventional treatment and also reduce the severity of pain.

摘要

皮肤移植(STSG)广泛应用于治疗创伤、烧伤和慢性创面引起的伤口。本研究旨在确定富含血小板纤维蛋白(PRF)在治疗供区创面时对需要 STSG 的烧伤患者创面的真实疗效。这是一项随机、三盲临床试验,于 2017 年 5 月至 2018 年 5 月在伊朗萨布泽瓦尔 Vasei 医院烧伤病房进行,将供区随机分为 2 组:PRF 组和对照组(凡士林油纱布),使用凡士林纱布。在干预组中,将 PRF 凝胶涂抹于创面,并用凡士林纱布和湿性敷料覆盖。相反,对照组仅应用凡士林纱布和湿性敷料。在第 8 天和第 15 天,分别采用配对 t 检验和 Wilcoxon 符号秩和检验进行结局评估。患者的平均年龄为 33.10±2.60 岁,51.50%为男性。PRF 组和对照组的平均愈合时间分别为 11.80±3.51 天和 16.30±4.32 天(<0.001)。PRF 组在第 8 天和第 15 天的换药时显示出明显更高的愈合率(<0.001 和<0.001)。此外,2 位 PRF 专家诊断的所有愈合指标的平均愈合时间在第 8 天和第 15 天也高于对照组(<0.001)。在第 8 天和第 15 天,2 组间的平均疼痛水平存在统计学显著差异(<0.001)。研究结果表明,与传统治疗相比,PRF 可显著缩短供区创面愈合时间,提高愈合率,减轻疼痛程度。

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