Sharma Arvind K, Kaur Arunpreet, Asthana Satyasheel S, Nongrum Ivanah P, Rai Siddharth, Sunaina Kumari
Physical Medicine and Rehabilitation, All India Institute of Medical Sciences Raebareli, Raebareli, IND.
Transfusion Medicine, All India Institute of Medical Sciences Raebareli, Raebareli, IND.
Cureus. 2024 Sep 5;16(9):e68709. doi: 10.7759/cureus.68709. eCollection 2024 Sep.
Introduction Chronic non-healing ulcers are defined as a discontinuity or break in the integrity of skin that is not healing in a reasonable period of time due to an underlying systemic etiology. Despite using conventional initial treatment and many other available dressing options, such wounds are difficult to completely heal, thus affecting the progress of rehabilitation measures and compromising functional improvement and quality of life. Materials and methods In this case series, platelet-rich fibrin (PRF) was applied to eight wounds from six patients. The patients included had various etiologies (including spinal cord injury, peripheral vascular disease, Guillain-Barré syndrome, and diabetic foot ulcer) with chronic non-healing wounds over different anatomical locations on the body. Pressure ulcer scale for healing (PUSH) score, surface area, and volume of the wounds were evaluated and monitored weekly after PRF dressing. We have applied PRF every week. On average, two PRF dressings were applied, the maximum being three applications. Results The maximum healing rate in terms of PUSH score was observed to be 3.84% per day, and the minimum was 1.19% per day. The maximum healing rate in terms of surface area was observed to be 5.89% per day, and the minimum was 1.78% per day. Three of the wounds showed complete closure. The maximum follow-up period was 10 weeks. The percentage mean Functional Independence Measure (FIM) improvement was calculated to be 15.87% ± 14.04 during the course of hospitalization after PRF application. Conclusion Based on the results, we can conclude that PRF showed accelerated improvement in the healing of chronic non-healing ulcers of various etiologies at different anatomical locations. It has proven to be a safe and effective method, thereby improving their quality of life and functional independence in performing activities of daily living. To our knowledge till date, no other study in a rehabilitation setting has been done on patients having non-healing ulcers due to various etiologies and at different anatomical locations.
引言 慢性难愈合溃疡被定义为皮肤完整性的连续性中断或破损，由于潜在的全身病因，在合理时间内无法愈合。尽管采用了传统的初始治疗方法和许多其他可用的敷料选项，但此类伤口仍难以完全愈合，从而影响康复措施的进展，并损害功能改善和生活质量。
材料与方法 在本病例系列中，富血小板纤维蛋白（PRF）应用于6例患者的8处伤口。纳入的患者病因各异（包括脊髓损伤、外周血管疾病、吉兰 - 巴雷综合征和糖尿病足溃疡），身体不同解剖部位存在慢性难愈合伤口。在应用PRF敷料后，每周评估和监测伤口的愈合压力溃疡量表（PUSH）评分、表面积和体积。我们每周应用PRF。平均应用两次PRF敷料，最多应用三次。
结果 观察到PUSH评分方面的最大愈合率为每天3.84%，最小为每天1.19%。表面积方面的最大愈合率为每天5.89%，最小为每天1.78%。3处伤口实现完全闭合。最长随访期为10周。应用PRF后住院期间，功能独立性测量（FIM）平均改善百分比计算为15.87%±14.04。
结论 根据结果，我们可以得出结论，PRF在不同解剖部位的各种病因所致慢性难愈合溃疡的愈合方面显示出加速改善。它已被证明是一种安全有效的方法，从而改善了患者的生活质量以及日常生活活动中的功能独立性。据我们所知，迄今为止，尚未有针对因各种病因且在不同解剖部位患有难愈合溃疡的患者在康复环境中进行的其他研究。
