Department of Wound Healing Center and Interventional Radiology and Vascular Surgery, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China.
Department of Pharmacology, School of Basic Medical Sciences, Peking University and Beijing Key Laboratory of Tumor Systems Biology, Peking University, 38 Xueyuan Road, Beijing, 100191, China.
Tissue Eng Regen Med. 2024 Dec;21(8):1255-1267. doi: 10.1007/s13770-024-00665-x. Epub 2024 Oct 14.
Surgical wounds that can't complete primary healing three weeks after surgery are called postoperative refractory wounds. Postoperative refractory wounds would bring great physical and life burdens to the patients and seriously affect their quality of life. To investigate the effect of platelet fibrin plasma (PFP) on postoperative refractory wound healing.
The composition of PFP was analyzed using blood routine and blood biochemicals. Clinical data were collected that met the inclusion criteria after treatment with PFP, and the efficacy of PFP was evaluated by wound healing rate and days to healing. Next, growth factor content in PFP, PRP, and PPP was analyzed using ELISA, and PFP-treated cells were applied to investigate the effect of PFP on fibroblast and endothelial cell function.
PFP component analysis revealed no statistical difference between platelet concentration in PFP and physiological concentration. Clinical statistics showed that PFP treatment was effective in the postoperative refractory wound (four-week wound healing rate > 90%), significantly better than continuous wound dressing. Meanwhile, our result also proved that PFP treatment significantly enhanced vascularization by upregulated the expression level of CD31 and improved granulation tissue thickness. Activated PFP, PRP, and PPP could continuously release growth factors in vitro and the amount of growth factors released by PRP and PFP was significantly higher than PPP. In vitro studies demonstrated that active PFP could improve cell proliferation, migration, adhesion, and angiogenesis in fibroblasts and endothelial cells.
Physiologically concentrated platelet plasma promoted wound healing and improved related cellular functions. The modified PFP (responsible for accelerating wound healing and enhancing the migration and proliferation of fibroblasts and endothelial cells) was prepared and analyzed for its clinical effectiveness in postoperative refractory wounds.
Physiologically concentrated platelet plasma promoted wound healing and improved related cellular functions. The preparation of PFP could significantly reduce the amount of prepared blood, with a good application value for postoperative wounds. PFP can be considered a treatment option, especially for postoperative refractory wounds.
术后 3 周仍无法完成一期愈合的手术切口称为术后难愈性创面。术后难愈性创面会给患者带来巨大的身体和生活负担，严重影响其生活质量。本研究旨在探讨血小板纤维蛋白血浆（platelet fibrin plasma，PFP）对术后难愈性创面愈合的影响。
采用血常规和血生化分析 PFP 的组成。收集符合纳入标准的 PFP 治疗后的临床资料，通过创面愈合率和愈合时间评估 PFP 的疗效。然后，采用 ELISA 分析 PFP、PRP 和 PPP 中的生长因子含量，并将 PFP 处理后的细胞用于研究 PFP 对成纤维细胞和血管内皮细胞功能的影响。
PFP 成分分析显示，PFP 中的血小板浓度与生理浓度无统计学差异。临床统计显示，PFP 治疗对术后难愈性创面（4 周创面愈合率>90%）有效，明显优于持续创面换药。同时，我们的结果也证明，PFP 治疗通过上调 CD31 的表达水平显著增强血管化，改善肉芽组织厚度，从而显著提高创面愈合率。体外实验表明，激活的 PFP、PRP 和 PPP 可持续释放生长因子，且 PRP 和 PFP 释放的生长因子量明显高于 PPP。体外研究表明，活性 PFP 可改善成纤维细胞和血管内皮细胞的增殖、迁移、黏附和血管生成能力。
生理浓度的血小板血浆促进创面愈合，改善相关细胞功能。本研究对改良后的 PFP（促进创面愈合，增强成纤维细胞和血管内皮细胞迁移和增殖）进行了分析，以评估其在术后难愈性创面中的临床疗效。
生理浓度的血小板血浆可促进创面愈合，改善相关细胞功能。PFP 的制备可显著减少所需血液量，在术后创面中具有良好的应用价值。PFP 可作为治疗选择，特别是用于术后难愈性创面。
