Knighton D R, Ciresi K F, Fiegel V D, Austin L L, Butler E L
Ann Surg. 1986 Sep;204(3):322-30. doi: 10.1097/00000658-198609000-00011.
Previous animal data showed that platelets contain growth factors that stimulate capillary endothelial migration (angiogenesis), fibroblast proliferation and migration, and collagen synthesis. This study utilized autologous platelet-derived wound healing factors (PDWHF) to treat 49 patients with chronic nonhealing cutaneous ulcers. Patients were classified on the basis of 20 clinical and wound status parameters to generate a wound severity index. Forty-nine patients--58% diabetic (20% with renal transplants); 16% with trauma, vasculitis, etc.; 14% with decubitus ulcers; and 6% each with venous stasis or arterial insufficiency--with a total of 95 wounds had received conventional wound care for an average of 198 weeks (range: 1-1820 weeks). After informed consent was obtained, patients received autologous PDWHF. Mean 100% healing time for all patients was 10.6 weeks. There was no abnormal tissue formation, keloid, or hypertrophic scarring. A multivariant analysis showed a direct correlation to 100% healing with initial wound size and the initiation of PDWHF therapy. This is the first clinical demonstration that locally acting growth factors promote healing of chronic cutaneous ulcers.
先前的动物数据表明，血小板含有刺激毛细血管内皮迁移（血管生成）、成纤维细胞增殖与迁移以及胶原蛋白合成的生长因子。本研究利用自体血小板衍生的伤口愈合因子（PDWHF）治疗49例慢性不愈合皮肤溃疡患者。根据20项临床和伤口状态参数对患者进行分类，以生成伤口严重程度指数。49例患者——58%为糖尿病患者（20%接受肾移植）；16%因创伤、血管炎等；14%患有褥疮溃疡；6%患有静脉淤滞或动脉供血不足——共有95处伤口，平均接受常规伤口护理198周（范围：1 - 1820周）。在获得知情同意后，患者接受自体PDWHF治疗。所有患者的平均100%愈合时间为10.6周。未出现异常组织形成、瘢痕疙瘩或肥厚性瘢痕。多变量分析显示，100%愈合与初始伤口大小和PDWHF治疗的开始直接相关。这是局部作用生长因子促进慢性皮肤溃疡愈合的首个临床证明。
