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富血小板血浆治疗改善藏毛窦疾病患者的术后恢复:一项随机对照临床试验。

Platelet-rich plasma treatment improves postoperative recovery in patients with pilonidal sinus disease: a randomized controlled clinical trial.

机构信息

Department of Surgery, Ankara University Faculty of Medicine, Ankara, Turkey.

Department of Hematology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

出版信息

BMC Surg. 2021 Oct 21;21(1):373. doi: 10.1186/s12893-021-01370-5.

Abstract

BACKGROUND

Pilonidal sinus is a common health problem. The current study aimed to compare the impact of autologous platelet-rich plasma (PRP) with that of minimally invasive techniques in terms of pain reduction, return to daily activities, quality of life, and duration of wound healing after open excision and secondary closure.

METHODS

Patients who were over 18 years old and had chronic PS disease between March 2018 and January 2019 were enrolled and randomly divided into three groups. Open surgery and moist dressings were applied to patients in group A. Open surgery followed by PRP application was performed on patients in group B. Group C underwent curettage of the sinus cavity followed by application of PRP. In this prospective randomized controlled study, patients completed questionnaires (including the Nottingham Health Profile (NHP), Short Form-36 (SF-36) and clinical information) before and after surgery. Demographics, preoperative characteristics, healing parameters, and quality-of-life scores were evaluated and calculated before and after surgery.

RESULTS AND CONCLUSION

The cavity volume and wound-healing time were compared among the groups on postoperative days 0, 2, 3, 4, and 21. Each patient was followed up throughout the process of wound healing, and follow-up was continued afterward to monitor the patients for recurrence. Due to the nature of the treatment that group C received, this group achieved shorter healing times and smaller cavity volume than the other groups. In contrast, the recovery time per unit of cavity volume was significantly faster in group B than in the other groups. Overall postoperative pain scores were significantly lower for both PRP groups (open surgery, group B; minimally invasive surgery, group C) than for group A (p < 0.001) and showed different time courses among the groups. In the treatment of PS disease, PRP application improves postoperative recovery in that it speeds patients' return to daily activities, reduces their pain scores and increases their quality of life. Trial registration The current study is registered on the public website ClinicalTrials.gov (ClinicalTrials.gov identifier number: NCT04697082; date: 05/01/2021).

摘要

背景

藏毛窦是一种常见的健康问题。本研究旨在比较富血小板血浆(PRP)与微创技术在减轻疼痛、恢复日常活动、生活质量以及切开引流二期缝合术后伤口愈合时间方面的影响。

方法

纳入 2018 年 3 月至 2019 年 1 月期间年龄超过 18 岁的慢性藏毛窦患者,并将其随机分为 3 组。A 组采用切开引流术和湿敷料;B 组在切开引流术后应用 PRP;C 组采用窦道搔刮后应用 PRP。在这项前瞻性随机对照研究中,患者在术前和术后完成问卷(包括诺丁汉健康调查问卷(NHP)、36 项简明健康状况量表(SF-36)和临床信息)。评估并计算术前和术后的人口统计学、术前特征、愈合参数和生活质量评分。

结果与结论

比较术后第 0、2、3、4 和 21 天的各组腔隙体积和伤口愈合时间。每个患者在伤口愈合过程中均接受随访,并且在愈合后继续随访以监测患者的复发情况。由于 C 组接受的治疗性质,该组的愈合时间和腔隙体积均小于其他组。相比之下,B 组每个腔隙单位的恢复时间比其他组都要快。与 A 组相比,B 组(切开引流术)和 C 组(微创术)的两组术后总体疼痛评分均显著降低(P < 0.001),并且组间的疼痛评分具有不同的时间进程。在藏毛窦疾病的治疗中,PRP 应用可改善术后恢复,使患者更快地恢复日常活动,减轻疼痛评分并提高生活质量。

试验注册

本研究在ClinicalTrials.gov 网站上注册(ClinicalTrials.gov 注册号:NCT04697082;注册日期:2021 年 5 月 1 日)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a57/8529773/2d09e0e465c7/12893_2021_1370_Fig1_HTML.jpg

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