Yang Chao, Zhao Juan, Zheng Danyu, Mei Lei, Jiang Bo
Department of Burn and Plastic Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China.
Department of Medical Cosmetology, Hejiang People's Hospital, Luzhou, Sichuan Province, China.
Medicine (Baltimore). 2025 Mar 7;104(10):e41720. doi: 10.1097/MD.0000000000041720.
This study is to evaluate the effectiveness of autologous platelet-rich fibrin (PRF) combined with ultra-pulsed carbon dioxide laser in treating cancellous bone-exposed wounds. A total of 65 patients with cancellous bone-exposed wounds were retrospectively analyzed selected. There were 35 cases in ultra-pulsed carbon dioxide laser + PRF group (Laser group, group L), and 30 cases in routine surgical debridement + PRF group (Routine group, group R). Parameters compared included the percentage of wound healing at intervals of 4, 8, 12, and 16 days post-treatment, growth status of wound granulation tissue, blood circulation, and pain scores before, during, and after the first debridement. Statistical analyses employed included the independent sample t test, repeated measures analysis of variance, chi-square test/Fisher exact test, Mann-Whitney U test, and Bonferroni correction. At 4, 8, 12 and 16 days after treatment, the wound healing percentages with (14.3% [8.6%, 22.8%], 28.6% [20.0%, 34.3%], 40.0% [34.3%, 54.3%], 62.8% [51.4%, 71.4%]) in group L were significantly higher than (3.3% [0.0%, 10.0%], 6.6% [3.3%, 16.7%], 16.7% [13.3%, 20.0%], 33.3% [23.3%, 46.7%], Z = 2.975, 3.452, 3.849, 4.178, P < .05) in group R. The granulation color observation scores of both groups were increased at 4, 8, 12 and 16 days after treatment, and the above granulation color observation scores in group L were obviously higher than those in group R (t = 6.028, 7.814, 5.209, 8.038, P < .05). Pain scores in group L during and after debridement were significantly lower than those in group R (t = 4.974, 6.740, P < .05). At 4, 8, 12 and 16 days after treatment, the wound blood perfusion volumes were risen in the 2 groups, and at 12 and 16 days after treatment, the wound blood perfusion volumes were significantly higher in group L than those in group R (z = 3.018, 3.247, P < .05). Compared to routine surgical debridement, the combination of PRF with ultra-pulsed carbon dioxide laser significantly enhances the percentage of wound healing, improves the granulation color and blood circulation, and reduces debridement pain in patients with cancellous bone-exposed wounds.
本研究旨在评估自体富血小板纤维蛋白（PRF）联合超脉冲二氧化碳激光治疗松质骨外露创面的有效性。回顾性分析选取的65例松质骨外露创面患者。超脉冲二氧化碳激光+PRF组（激光组，L组）35例，常规手术清创+PRF组（常规组，R组）30例。比较的参数包括治疗后4、8、12和16天的创面愈合百分比、创面肉芽组织生长状况、血液循环以及首次清创前、清创时和清创后的疼痛评分。采用的统计分析方法包括独立样本t检验、重复测量方差分析、卡方检验/费舍尔精确检验、曼-惠特尼U检验和邦费罗尼校正。治疗后4、8、12和16天，L组的创面愈合百分比（分别为14.3%[8.6%，22.8%]、28.6%[20.0%，34.3%]、40.0%[34.3%，54.3%]、62.8%[51.4%，71.4%]）显著高于R组（分别为3.3%[0.0%，10.0%]、6.6%[3.3%，16.7%]、16.7%[13.3%，20.0%]、33.3%[23.3%，46.7%]，Z = 2.975、3.452、3.849、4.178，P <.05）。两组在治疗后4、8、12和16天的肉芽颜色观察评分均升高，且L组上述肉芽颜色观察评分明显高于R组（t = 6.028、7.814、5.209、8.038，P <.05）。L组清创时及清创后的疼痛评分显著低于R组（t = 4.974、6.740，P <.05）。治疗后4、8、12和16天，两组创面血灌注量均升高，且治疗后12和16天，L组创面血灌注量显著高于R组（z = 3.018、3.247，P <.05）。与常规手术清创相比，PRF联合超脉冲二氧化碳激光显著提高了松质骨外露创面患者的创面愈合百分比，改善了肉芽颜色和血液循环，并减轻了清创疼痛。
