The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
Int J Low Extrem Wounds. 2024 Jun;23(2):275-282. doi: 10.1177/15347346211050710. Epub 2021 Oct 27.
Refractory wounds present a complex and serious clinical dilemma in plastic and reconstructive surgery. However, there are currently no standard guidelines for the treatment of refractory wounds. Artificial dermis (AD) has achieved some satisfactory results, but also has some limitations. Autologous platelet-rich plasma (PRP), as a cell-therapy material, was a valuable and safe treatment dressing for chronic non-healing wounds. This study aimed to evaluate the efficacies of artificial dermis (AD) with and without autologous platelet-rich plasma (PRP) in patients with refractory wounds. Sixteen patients with refractory wounds were randomly allocated to autologous PRP therapy combined with artificial dermis (PRP + AD [N = 8]) or an artificial dermis program only (AD [N = 8]). We compared the efficacies of the two methods in terms of times to wound healing, infection control, and AD vascularization, as well as hospitalization days and eventual clinical outcomes.13 patients achieved complete healing, including seven (87.5%) in the PRP + AD group and six (75.0%) in the AD group (P > .05). The times to wound healing, infection control, and AD vascularization, and hospitalization time after transfer were significantly shorter in the PRP + AD group compared with the AD group (P < .05). In conclusion, the combination of AD and PRP promoted refractory wound healing and shortened waiting times compared with simple dermal grafts.
难治性创面在整形和重建外科中呈现出复杂而严重的临床困境。然而,目前对于难治性创面尚无标准的治疗指南。人工真皮(AD)已取得一些令人满意的效果,但也存在一些局限性。富含血小板的自体血浆(PRP)作为一种细胞治疗材料,是治疗慢性不愈创面的一种有价值且安全的治疗敷料。本研究旨在评估人工真皮(AD)联合和不联合自体血小板丰富血浆(PRP)治疗难治性创面的疗效。将 16 例难治性创面患者随机分为 PRP 联合人工真皮(PRP+AD [N=8])或单纯人工真皮治疗(AD [N=8])。我们比较了两种方法在创面愈合时间、感染控制、AD 血管化以及住院天数和最终临床结果方面的疗效。13 例患者达到完全愈合,其中 PRP+AD 组 7 例(87.5%),AD 组 6 例(75.0%)(P>.05)。PRP+AD 组的创面愈合时间、感染控制时间、AD 血管化时间以及转皮后住院时间均明显短于 AD 组(P<.05)。总之,与单纯真皮移植相比,AD 联合 PRP 可促进难治性创面愈合,并缩短等待时间。