Salgado-Pacheco Verónica, Oller Ramon, Ferrer-Solà Marta, Masó-Albareda Clara, Casals-Zorita Marta, Sarri Elisabet, Puigoriol-Juvanteny Emma, Espaulella-Panicot Joan, Otero-Viñas Marta
Tissue Repair and Regeneration Laboratory (TR2Lab), Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IrisCC), Vic, Spain.
Department of Biosciences, Faculty of Science, Technology and Engineering, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain.
Adv Wound Care (New Rochelle). 2024 Nov 7. doi: 10.1089/wound.2024.0102.
Autologous platelet-rich plasma (PRP) has shown promising outcomes in treating wounds, but the profile of patients benefiting most from this therapy is not known. This study aimed to identify influential variables in the success of this therapy, analyzing its personalized therapeutic potential for complex wounds. A prospective observational study was conducted in elderly patients with complex wounds receiving autologous PRP. Patient's data about sociodemographic parameters, comorbidities, frailty (FI-VIG score), complete blood count including albumin, wound depth, location, chronicity, and etiology were collected at the beginning of the study. The wound area was monitored weekly. The data were analyzed using descriptive and inferential statistics, longitudinal data analysis, and survival analysis. Ninety-seven elderly patients were included. The FI-VIG, baseline wound area, depth, and etiology were significantly correlated with wound outcome. Strong differences in wound area variation from treatment initiation were observed in healed wounds (13% reduction/week) compared with stagnant and complicated wounds (1 and 2% reduction/week, respectively). The healing time analysis showed that nearly 80% of patients required at least 15 weeks for complete healing. In addition, patients with smaller wound sizes, younger age, or lower FI-VIG scores had shorter healing times. This is the first study that identifies prognostic indicators for wound outcomes to guide clinician decision-making for using autologous PRP. It also highlights the relevance of patient health baseline and wound features and evolution for the success of this therapy. This study demonstrates that personalizing autologous PRP therapy to treat complex wounds in elderly patients is possible.
自体富血小板血浆（PRP）在治疗伤口方面已显示出良好的效果，但最能从这种治疗中受益的患者特征尚不清楚。本研究旨在确定该治疗成功的影响因素，分析其对复杂伤口的个性化治疗潜力。对接受自体PRP治疗的老年复杂伤口患者进行了一项前瞻性观察研究。在研究开始时收集了患者的社会人口统计学参数、合并症、虚弱程度（FI-VIG评分）、包括白蛋白在内的全血细胞计数、伤口深度、位置、慢性程度和病因等数据。每周监测伤口面积。使用描述性和推断性统计、纵向数据分析和生存分析对数据进行分析。纳入了97名老年患者。FI-VIG、基线伤口面积、深度和病因与伤口愈合结果显著相关。与停滞和复杂伤口（分别为每周1%和2%的减少率）相比，愈合伤口（每周减少13%）从治疗开始时伤口面积变化有很大差异。愈合时间分析表明，近80%的患者需要至少15周才能完全愈合。此外，伤口尺寸较小、年龄较轻或FI-VIG评分较低的患者愈合时间较短。这是第一项确定伤口愈合结果预后指标以指导临床医生使用自体PRP决策的研究。它还强调了患者健康基线以及伤口特征和演变对该治疗成功的相关性。这项研究表明，对老年患者的复杂伤口进行自体PRP治疗个性化是可行的。
