Yang Mengling, Deng Bo, Hao Wei, Jiang Xiaoyan, Chen Yan, Wang Min, Yuan Yi, Chen Meirong, Wu Xiaohua, Du Chenzhen, Armstrong David G, Guo Lian, Deng Wuquan, Wang Hongyan
Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China.
Chongqing Key Laboratory of Emergency Medicine, Chongqing, China.
Regen Ther. 2025 Feb 21;28:625-632. doi: 10.1016/j.reth.2025.02.005. eCollection 2025 Mar.
Diabetic foot ulcers (DFUs) are severe complications of diabetes, often leading to chronic wounds, amputations, and increased mortality risk. Platelet concentrates (PCs)-natural biomaterials utilized in regenerative medicine-have garnered attention for their capacity to enhance tissue repair and wound healing. This study reviews the preparation methods, biological mechanisms, and clinical efficacy of three generations of PCs: platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factors (CGF). Comparative analysis reveals that PRP, the first generation, provides abundant growth factors but relies on anticoagulants, which may hinder fibrin formation and tissue adhesion. PRF, as the second generation, eliminates anticoagulants, forming a fibrin matrix that sustains growth factor release and enhances cell migration. CGF, the latest advancement, employs refined centrifugation to achieve higher growth factor concentrations and a denser fibrin matrix, accelerating tissue regeneration. Case series results demonstrated superior wound healing outcomes with CGF, including faster epithelialization and reduced healing time compared to PRP and PRF. These findings underscore CGF's potential as the most effective PC for managing DFUs, supporting its broader clinical adoption in advanced wound care.
糖尿病足溃疡(DFUs)是糖尿病的严重并发症,常导致慢性伤口、截肢,并增加死亡风险。血小板浓缩物(PCs)——再生医学中使用的天然生物材料——因其增强组织修复和伤口愈合的能力而受到关注。本研究综述了三代血小板浓缩物的制备方法、生物学机制和临床疗效:富血小板血浆(PRP)、富血小板纤维蛋白(PRF)和浓缩生长因子(CGF)。对比分析表明,第一代PRP提供了丰富的生长因子,但依赖抗凝剂,这可能会阻碍纤维蛋白形成和组织黏附。第二代PRF消除了抗凝剂,形成了一种纤维蛋白基质,可维持生长因子释放并增强细胞迁移。最新进展的CGF采用精细离心以实现更高的生长因子浓度和更致密的纤维蛋白基质,从而加速组织再生。病例系列结果表明,与PRP和PRF相比,CGF具有更好的伤口愈合效果,包括更快的上皮化和更短的愈合时间。这些发现强调了CGF作为治疗DFUs最有效血小板浓缩物的潜力,支持其在高级伤口护理中更广泛的临床应用。