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沙特阿拉伯开展的一系列自体富血小板血浆注射治疗慢性溃疡的病例。

A case series of autologous platelet-rich plasma injection in treating chronic ulcers conducted in Saudi Arabia.

作者信息

Tabanjeh Sinan F, Al-Malki Talal, Kharabsheh Rola Al, Mahmood Danish

机构信息

Kahel Specialized Centre, Riyadh, Saudi Arabia.

Department of Orthopedics and Trauma, Security Forces Hospital Program, Riyadh, Saudi Arabia.

出版信息

Int J Health Sci (Qassim). 2023 Mar-Apr;17(2):46-56.

Abstract

OBJECTIVE

This is a case series study of 14 cases of chronic unhealed ulcers involving patients of 19-85 years, aimed to demonstrate the positive therapeutic outcomes of using autologous platelet rich plasma (PRP) in diabetic foot ulcer (DFU) and other chronic wound healing.

METHODS

This is a formal consecutive clinical case series. Patients with chronic unhealed ulcers were enrolled from the amputation prevention clinic by an interdisciplinary team includes podiatrist, general surgeon, orthopedic, vascular surgeon, and wound care nurses at Kahel Specialized Centre, a specialized center for managing foot and ankle diseases, located in Riyadh, Saudi Arabia. Those patients who presented with chronic wounds and showed no significant wound reduction despite following the standard wound care protocol were included in the study. There were no specific predetermined exclusion criteria when considering patients for treatment with this modality.

RESULTS

In this case series, majority (80%) of the patients were above 50 years of age, and 10 (66.7%) patients were male and 5 (33.3%) were female. Of all the cases presented to the amputation prevention clinic, majority (73.3%) reported suffering from type 2 diabetes mellitus (DM) and also, one reported type 1 DM [6.7%]). All the cases of DFU received a combination of hydrogel and autologous PRP treatment and were put of suitable offloading devices, except one case received a combination of Cadexomer iodine, hydrogel and PRP treatment. In the present case series involving 3-14 weeks of the treatment duration, only 2-3 doses of autologous PRP provided complete healing and or maximum wound closure.

CONCLUSION

Autologous PRP therapy is efficacious in facilitating, enhancing wound healing and aids in complete wound closure. This case series was limited in term of the sample size which is the number patients enrolled for the study, hence, the study finding remain inconclusive to some extent and hence, further study is required with greater number of sample size. The strength of this study is that it is the first study in Saudi Arabia and gulf region, to report the beneficial effect of PRP in chronic unhealed ulcers including diabetic ulcers.

摘要

目的

本研究为一项包含14例慢性未愈合溃疡患者的病例系列研究,患者年龄在19至85岁之间,旨在证明使用自体富血小板血浆(PRP)治疗糖尿病足溃疡(DFU)及其他慢性伤口愈合的积极治疗效果。

方法

这是一个正式的连续临床病例系列。慢性未愈合溃疡患者由一个跨学科团队从截肢预防诊所招募,该团队包括足病医生、普通外科医生、骨科医生、血管外科医生以及位于沙特阿拉伯利雅得的足部和踝关节疾病专科中心Kahel专科中心的伤口护理护士。那些患有慢性伤口且尽管遵循了标准伤口护理方案但伤口仍无明显缩小的患者被纳入研究。在考虑采用这种治疗方式的患者时,没有特定的预先设定的排除标准。

结果

在这个病例系列中,大多数(80%)患者年龄在50岁以上,男性10例(66.7%),女性5例(33.3%)。在所有到截肢预防诊所就诊的病例中,大多数(73.3%)报告患有2型糖尿病(DM),还有1例报告患有1型糖尿病[6.7%])。除1例接受卡地姆碘、水凝胶和PRP联合治疗外,所有DFU病例均接受了水凝胶和自体PRP联合治疗,并使用了合适的减压装置。在本病例系列中,治疗持续时间为3至14周,仅2至3剂自体PRP就实现了完全愈合和/或最大程度的伤口闭合。

结论

自体PRP疗法在促进、增强伤口愈合及帮助实现完全伤口闭合方面是有效的。本病例系列在样本量(即纳入研究的患者数量)方面存在局限性,因此,研究结果在一定程度上仍无定论,所以需要进行更大样本量的进一步研究。本研究的优势在于,它是沙特阿拉伯和海湾地区首个报告PRP对包括糖尿病溃疡在内的慢性未愈合溃疡有益作用的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d16/9986877/ad440248c8c1/IJHS-17-46-g002.jpg

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