Liu Xiang, Li Xiangjun, Wei Wei, Zhang Xiang, Fang Zheng, Chen Zixiu, Chen Pingxiang, Li Haihong
Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
Department of Wound Repair, Southern University of Science and Technology Hospital, Shenzhen, China.
Front Surg. 2023 Jan 9;9:1003691. doi: 10.3389/fsurg.2022.1003691. eCollection 2022.
Refractory wounds are a major global health problem that not only affects the quality of life, but also causes significant physical, psychological and economic burdens. How to promote wound healing has become the main goal of clinicians. To evaluate the safety and efficacy of local autologous platelet rich plasma (PRP) injection combined with platelet rich fibrin (PRF) filling as the main treatment for refractory wounds. In the study, autologous PRP and PRF were prepared from whole blood. Twelve patients, each having a refractory wound, were included. The wounds were debrided first to remove necrotic and infected tissues, and then were given once or twice local PRP injection combined with PRF filling treatment. The total healing time (the time from admission to wound healing) and the healing time after PRP/PRF combined treatment (the time from PRP treatment to wound healing), as well as the adverse events were recorded. The results showed that the wound duration before the combination treatment was 10.48 ± 3.66 weeks, and the mean area/volume (for sinus or fistula) of the wounds was 8.23 ± 2.67 cm/9.54 ± 2.13 cm (for sinus or fistula). All wounds healed after once or twice PRP/PRF combined treatment. The total healing time was 26.91 ± 8.01 days, and the healing time after the combined treatment was 16.36 ± 7.47 days. No adverse events were reported during the treatment and follow-up period. Our case series demonstrate the safety and synergistic effectiveness of local autologous PRP injection combined with PRF filling as the main treatment for refractory wounds. Platelet concentrates is not only an adjuvant treatment for chronic wounds, but a potential substitute for chronic wounds, especially in sinuses and fistulas.
难治性伤口是一个重大的全球健康问题，不仅影响生活质量，还会造成巨大的身体、心理和经济负担。如何促进伤口愈合已成为临床医生的主要目标。为评估局部自体富血小板血浆（PRP）注射联合富血小板纤维蛋白（PRF）填充作为难治性伤口主要治疗方法的安全性和有效性。在该研究中，从全血中制备自体PRP和PRF。纳入12例患有难治性伤口的患者。首先对伤口进行清创以清除坏死和感染组织，然后给予局部PRP注射联合PRF填充治疗一次或两次。记录总愈合时间（从入院到伤口愈合的时间）以及PRP/PRF联合治疗后的愈合时间（从PRP治疗到伤口愈合的时间），以及不良事件。结果显示，联合治疗前伤口持续时间为10.48±3.66周，伤口的平均面积/体积（对于窦道或瘘管）为8.23±2.67 cm/9.54±2.13 cm（对于窦道或瘘管）。所有伤口在接受一次或两次PRP/PRF联合治疗后均愈合。总愈合时间为26.91±8.01天，联合治疗后的愈合时间为16.36±7.47天。在治疗和随访期间未报告不良事件。我们的病例系列证明了局部自体PRP注射联合PRF填充作为难治性伤口主要治疗方法的安全性和协同有效性。血小板浓缩物不仅是慢性伤口的辅助治疗方法，而且是慢性伤口，尤其是窦道和瘘管的潜在替代治疗方法。
