Division of Plastic and Reconstructive Surgery, Department of Surgery.
Department of Orthopaedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei.
Ann Plast Surg. 2024 Jan 1;92(1S Suppl 1):S2-S11. doi: 10.1097/SAP.0000000000003796.
The skin is the largest organ in the human body and serves as a barrier for protective, immune, and sensory functions. Continuous and permanent exposure to the external environment results in different levels of skin and extracellular matrix damage. During skin wound healing, the use of good dressings and addition of growth factors to the wound site can effectively modulate the rate of wound healing. A dressing containing bioactive substances can absorb wound exudates and reduce adhesion between the wound and dressing, whereas growth factors, cytokines, and signaling factors can promote cell motility and proliferation.
We prepared a functional wound dressing by combining platelet-rich plasma (PRP) and zwitterionic hydrogels. Functional wound dressings are rich in various naturally occurring growth factors that can effectively promote the healing process in various types of tissues and absorb wound exudates to reduce adhesion between wounds and dressings. Furthermore, PRP-incorporated zwitterionic hydrogels have been used to repair full-thickness wounds in Sprague-Dawley rats with diabetes (DM SD).
Fibroblasts and keratinocytes were cultured with PRP, zwitterionic hydrogels, and PRP-incorporated zwitterionic hydrogels to assess cell proliferation and specific gene expression. Furthermore, PRP-incorporated zwitterionic hydrogels were used to repair full-thickness skin defects in DM SD rats.
The swelling ratio of hydrogel, hydrogel + PRP1000 (108 platelets/mL), and hydrogel + PRP1000 (109 platelets/mL) groups were similar (~07.71% ± 1.396%, 700.17% ± 1.901%, 687.48% ± 4.661%, respectively) at 144 hours. The tensile strength and Young modulus of the hydrogel and hydrogel + PRP10000 groups were not significantly different. High concentrations of PRP (approximately 108 and 109 platelets/mL) effectively promoted the proliferation of fibroblasts and keratinocytes. The zwitterionic hydrogels were not cytotoxic to any cell type. High PRP concentration-incorporated zwitterionic hydrogels increased the rate of cell proliferation and significantly increased the expression of characteristic genes such as collagen, fibronectin, involucrin, and keratin. Subsequently, zwitterionic hydrogels with high PRP concentrations were used to repair full-thickness skin defects in DM SD rats, and a wound healing rate of more than 90% was recorded on day 12.
PRP contains high concentrations of growth factors that promote cell viability, enhance specific gene expression, and have a high medical value in cell therapy. Zwitterionic hydrogels have a 3-dimensional interconnected microporous structure and can resist cell adhesion without causing cytotoxicity. Platelet-rich plasma-incorporated zwitterionic hydrogels further enhance the cellular properties and provide an effective therapeutic option for wound healing.
皮肤是人体最大的器官，具有保护、免疫和感觉等功能。由于持续且永久地暴露于外部环境中，皮肤及其细胞外基质会受到不同程度的损伤。在皮肤伤口愈合过程中，使用良好的敷料并在伤口部位添加生长因子可以有效调节伤口愈合速度。含有生物活性物质的敷料可以吸收伤口渗出物并减少伤口与敷料之间的粘连，而生长因子、细胞因子和信号转导因子可以促进细胞的迁移和增殖。
我们通过将富含血小板的血浆（PRP）与两性离子水凝胶结合来制备功能性伤口敷料。功能性伤口敷料富含各种天然存在的生长因子，可有效促进各种组织的愈合过程，并吸收伤口渗出物，减少伤口与敷料之间的粘连。此外，已将 PRP 掺入的两性离子水凝胶用于修复患有糖尿病（DM SD）的 Sprague-Dawley 大鼠的全层皮肤缺损。
用 PRP、两性离子水凝胶和 PRP 掺入的两性离子水凝胶培养成纤维细胞和角质形成细胞，以评估细胞增殖和特定基因表达。此外，还使用 PRP 掺入的两性离子水凝胶修复 DM SD 大鼠的全层皮肤缺损。
水凝胶、水凝胶+ PRP1000（108 个血小板/mL）和水凝胶+ PRP1000（109 个血小板/mL）组的水凝胶的溶胀比在 144 小时内相似（分别约为 07.71%±1.396%、700.17%±1.901%、687.48%±4.661%）。水凝胶和水凝胶+ PRP10000 组的拉伸强度和杨氏模量没有明显差异。高浓度的 PRP（约 108 和 109 个血小板/mL）可有效促进成纤维细胞和角质形成细胞的增殖。两性离子水凝胶对任何细胞类型均无细胞毒性。高 PRP 浓度掺入的两性离子水凝胶增加了细胞增殖率，并显著增加了胶原蛋白、纤维连接蛋白、内披蛋白和角蛋白等特征基因的表达。随后，将高 PRP 浓度的两性离子水凝胶用于修复 DM SD 大鼠的全层皮肤缺损，第 12 天记录到超过 90%的伤口愈合率。
富含血小板的血浆（PRP）含有高浓度的生长因子，可促进细胞活力，增强特定基因表达，在细胞治疗中具有很高的医学价值。两性离子水凝胶具有 3 维相互连通的微孔结构，可抵抗细胞黏附而无细胞毒性。PRP 掺入的两性离子水凝胶进一步增强了细胞特性，为伤口愈合提供了有效的治疗选择。
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