Department of Hematology and Oncology, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China.
Department of Blood Transfusion, School of Medicine, Jinling Hospital, Nanjing University, China.
Adv Clin Exp Med. 2023 Aug;32(8):865-872. doi: 10.17219/acem/159088.
Refractory abdominal wounds are commonly complicated by surgical site infections, which prolong hospital stays and increase medical costs. There is little clinical data on the use of allogeneic platelet gel (PG) therapy for refractory infected wounds.
This study aimed to evaluate the efficacy and safety of allogeneic PGs in the treatment of refractory abdominal wounds.
A prospective single-center study was performed in a national abdominal trauma referral center between June 2019 and June 2021. A total of 11 patients with refractory abdominal wounds were treated with allogeneic PGs after the failure of standard medical treatments. The PGs were derived from platelets collected from healthy donors using apheresis, and each PG was tested for platelet count, transfusion-related diseases, aerobic and anaerobic bacteria, and growth factor concentration. Clinical efficacy was evaluated by assessing the wound surface and observing the condition of the wound, including wound area and percentage of granulation.
The median age of the patients was 37 years (1st quartile, 3rd quartile (Q1, Q3): 31-55 years), median (Q1, Q3) hemoglobin level was 95 g/L (78-120 g/L) and median (Q1, Q3) serum albumin level was 39.9 g/L (34.9-42.7 g/L). The PG platelet count was 976.5 ±174.9×109/L. Results of transfusion-associated contagion tests for aerobic and anaerobic bacteria were negative. Growth factor contents (pg/mL) were: for transforming growth factor beta 1 (TGF-β1); 2542.39 ±430.60, for platelet-derived growth factor BB (PDGF-BB); 23230.03 ±4236.14 and FOR vascular endothelial growth factor (VEGF); 91.41 ±23.31. The rate of wound healing was 100%, and the median (Q1, Q3) healing time was 30 days (18-40 days). The follow-up period was 5-27 months, during which no recurrence of the wounds was found.
The present study demonstrated that allogeneic PGs are a safe and effective treatment for refractory abdominal wounds.
难治性腹部伤口常并发手术部位感染，这会延长住院时间并增加医疗费用。异体血小板凝胶 (PG) 治疗难治性感染性伤口的临床数据很少。
本研究旨在评估异体 PG 在治疗难治性腹部伤口中的疗效和安全性。
这是一项 2019 年 6 月至 2021 年 6 月在国家腹部创伤转诊中心进行的前瞻性单中心研究。共有 11 例难治性腹部伤口患者在标准治疗失败后接受异体 PG 治疗。PG 来自通过单采术从健康供体采集的血小板，每个 PG 都经过血小板计数、输血相关疾病、需氧菌和厌氧菌以及生长因子浓度检测。通过评估伤口表面和观察伤口状况（包括伤口面积和肉芽百分比）来评估临床疗效。
患者的中位年龄为 37 岁（第 1 四分位数，第 3 四分位数 (Q1，Q3)：31-55 岁），中位（Q1，Q3）血红蛋白水平为 95 g/L（78-120 g/L），中位（Q1，Q3）血清白蛋白水平为 39.9 g/L（34.9-42.7 g/L）。PG 的血小板计数为 976.5±174.9×109/L。需氧菌和厌氧菌输血相关传染病检测结果均为阴性。生长因子含量（pg/mL）分别为：转化生长因子-β1（TGF-β1）为 2542.39±430.60，血小板衍生生长因子 BB（PDGF-BB）为 23230.03±4236.14，血管内皮生长因子（VEGF）为 91.41±23.31。愈合率为 100%，中位（Q1，Q3）愈合时间为 30 天（18-40 天）。随访时间为 5-27 个月，在此期间未发现伤口复发。
本研究表明，异体 PG 是治疗难治性腹部伤口的一种安全有效的方法。
