Department of Orthopedics, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China.
Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China.
J Orthop Surg Res. 2022 Nov 19;17(1):497. doi: 10.1186/s13018-022-03401-0.
Currently, among wounds with large skin tissue defects caused by various reasons, the treatment of refractory wounds is still a major clinical problem. This study is aimed to preliminarily assess the therapeutic potentials of platelet-rich plasma (PRP) in refractory wounds with exposed tendons, as well as corresponding efficacy and safety.
A total of 12 patients (5 males and 7 females) with refractory wounds and exposed tendons who were admitted to our hospital from June 2018 to December 2020 were included in this study. After the preparation of PRP, the included patients underwent the PRP injection after the debridement of wounds, and the efficacy and prognosis were assessed by the same group of senior surgeons.
The average age of included patients was 42.7 ± 12.9 years, and the causes of injury included traffic accidents (3 cases), contusion (2 cases), burns (2 cases), diabetes complications (4 cases), and melanoma complications (1 cases). The average healing time was 23.0 ± 5.0 days, and the mean size of the wound was 3.1 × 5.1 cm. During the whole treatment process, Vancouver Scar Scale (VSS) decreased from 7.4 ± 1.6 before PRP treatment to 3.6 ± 0.9 after treatment (P < 0.001), Manchester Scar Scale (MSS) decreased from 12.3 ± 4.5 before PRP treatment to 5.4 ± 1.2 after treatment (P < 0.001), and no redness and swelling were observed around wounds, the size and degree of wounds gradually reduced, the coverage rate of granulation tissue was acceptable, overall quality of scar was relatively good, skin sensitivity around wounds was normal, there was no local wounds secretion, and postoperative patient's satisfaction was relatively good during follow-up.
Our study has preliminarily indicated that PRP can promote the wounds healing, reduce the inflammation around wounds, and improve the granulation tissue and angiogenesis, thereby effectively polishing up the safety and efficacy.
目前，对于各种原因导致的大面积皮肤组织缺损创面，尤其是外露肌腱的难治性创面，其治疗仍然是临床一大难题。本研究旨在初步评估富血小板血浆（PRP）治疗外露肌腱难治性创面的治疗潜力及相应的疗效和安全性。
回顾性分析 2018 年 6 月至 2020 年 12 月我院收治的 12 例难治性外露肌腱创面患者的临床资料。对患者进行 PRP 制备，清创后给予 PRP 注射治疗，由同组高年资医师评估疗效及预后。
患者年龄为 42.7±12.9 岁，其中交通伤 3 例、碾压伤 2 例、烧伤 2 例、糖尿病并发症 4 例、黑色素瘤并发症 1 例。创面愈合时间为 23.0±5.0d，创面大小为 3.1cm×5.1cm。治疗后患者温哥华瘢痕量表（VSS）评分由治疗前的 7.4±1.6 分降至 3.6±0.9 分（P<0.001），曼彻斯特瘢痕量表（MSS）评分由治疗前的 12.3±4.5 分降至 5.4±1.2 分（P<0.001），且治疗过程中患者创面周围均无红肿，创面逐渐缩小，肉芽组织覆盖良好，瘢痕总体质量较好，周围皮肤感觉正常，无局部创面分泌物，随访时患者满意度较高。
PRP 可促进创面愈合，减轻创面周围炎症反应，改善肉芽组织及血管生成，从而有效提高疗效，安全性较好。
