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富血小板血浆在减轻皮肤移植供区疼痛、瘙痒及促进伤口愈合中的作用

The Role of Platelet-Rich Plasma in Reducing Pain, Pruritis, and Improving Wound Healing of Skin Graft Donor Site.

作者信息

Ali Sheikh Sarfraz, Ahmad Imran, Khurram Mohammed Fahud, Chaudhury Gautam, Karad Somnath, Tripathi Sudanshu, Sharma Aditi

机构信息

Department of Plastic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.

出版信息

Indian J Plast Surg. 2022 Dec 22;55(4):376-382. doi: 10.1055/s-0042-1759502. eCollection 2022 Dec.

Abstract

Wound healing is a dynamic and complex process. Therefore, no single agent can efficiently mediate all aspects of the wound healing process. Split-thickness graft has become a workhorse of plastic surgery for wound or raw area cover. In this study, we evaluate the effectiveness of autologous platelet-rich plasma (PRP) on the donor site and its effect in pain, purities, and epithelization.  This is a prospective study. A total of 15 patients were included who underwent split skin grafting for burns, trauma, or post-tumor excision raw area. PRP was prepared using standard described procedure. The donor site raw area after harvesting split-thickness graft was measured and the surface area was divided into two equal halves. One half was dressed using PRP and the other half was dressed using paraffin gauze piece only. The dressings were changed weekly for 3 weeks.  We found significant reduction in severity of pain and pruritis in the PRP group as compared with control group. Epithelization was faster in the PRP group on day 7 and 14, but the overall healing time was nearly the same by day 21. The side-by-side dressing thus show a definite improvement in the post-split-thickness skin graft wound care and PRP as a good dressing alternative.  Autologous PRP is very effective adjuvant in management of skin graft donor site. Its role in relieving pain and pruritis over donor site significantly improves patient's discomfort postoperatively. It helps in early and painless wound healing. However, we recommend for larger clinical study for better understanding of the efficacy of this blood product.

摘要

伤口愈合是一个动态且复杂的过程。因此,没有单一的药物能够有效地介导伤口愈合过程的所有方面。中厚皮片移植已成为整形外科用于覆盖伤口或创面的常用方法。在本研究中,我们评估了自体富血小板血浆(PRP)对供皮区的有效性及其在疼痛、渗出和上皮化方面的作用。

这是一项前瞻性研究。共纳入15例因烧伤、创伤或肿瘤切除术后创面而接受中厚皮片移植的患者。PRP采用标准描述的程序制备。取中厚皮片后测量供皮区创面面积,并将其表面积分为两个相等的部分。一半用PRP进行包扎,另一半仅用石蜡纱布片进行包扎。每周更换敷料,持续3周。

我们发现,与对照组相比,PRP组的疼痛和瘙痒严重程度显著降低。在第7天和第14天,PRP组的上皮化速度更快,但到第21天时总体愈合时间几乎相同。这种并列包扎方式在中厚皮片移植术后伤口护理方面显示出明显改善,PRP是一种很好的包扎替代品。

自体PRP在皮肤移植供皮区的处理中是非常有效的辅助手段。它在减轻供皮区疼痛和瘙痒方面的作用显著改善了患者术后的不适感。它有助于伤口早期无痛愈合。然而,我们建议进行更大规模的临床研究,以更好地了解这种血液制品的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e85/9859680/105a58f6ab56/10-1055-s-0042-1759502-i21101484-1.jpg

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