Riza Stefania-Mihaela, Porosnicu Andrei-Ludovic, Cepi Patricia-Alina, Parasca Sorin Viorel, Sinescu Ruxandra-Diana
Department 11, Discipline Plastic and Reconstructive Surgery, Bucharest Clinical Emergency Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania.
Department of Plastic Surgery and Reconstructive Microsurgery, Elias Emergency University Hospital, 011461 Bucharest, Romania.
Biomedicines. 2025 Jul 25;13(8):1827. doi: 10.3390/biomedicines13081827.
: Chronic wounds represent a persistent clinical challenge and impose a considerable burden on healthcare systems. These lesions often require multidisciplinary management due to underlying factors such as microbial colonization, impaired immunity, and vascular insufficiencies. Regenerative therapies, particularly autologous approaches, have emerged as promising strategies to enhance wound healing. Adipose tissue-derived stem cells (ADSCs) and platelet-rich plasma (PRP) may improve outcomes through paracrine effects and growth factor release. : A prospective observational study was conducted on 31 patients with chronic wounds that were unresponsive to conservative treatment for over six weeks. Clinical and photographic evaluations were employed to monitor healing. All patients underwent surgical debridement, with adjunctive interventions-negative pressure wound therapy, grafting, or flaps-applied as needed. PRP infiltration and/or autologous adipose tissue transfer were administered based on wound characteristics. Wound area reduction was the primary outcome measure. : The cohort included 17 males and 14 females (mean age: 59 years). Etiologies included venous insufficiency (39%), diabetes mellitus (25%), arterial insufficiency (16%), and trauma (16%). Most lesions (84%) were located on the lower limbs. All patients received PRP therapy; five underwent combined PRP and fat grafting. Over the study period, 64% of the patients exhibited >80% wound area reduction, with complete healing in 48.3% and a mean healing time of 49 days. PRP therapy proved to be a safe, effective, and adaptable treatment, promoting substantial healing in chronic wounds. Autologous adipose tissue transfer did not confer additional benefit. PRP may warrant inclusion in national treatment protocols.
慢性伤口是一个持续存在的临床挑战，给医疗系统带来了相当大的负担。由于微生物定植、免疫功能受损和血管功能不全等潜在因素，这些伤口通常需要多学科管理。再生疗法，尤其是自体疗法，已成为促进伤口愈合的有前景的策略。脂肪组织来源的干细胞（ADSCs）和富血小板血浆（PRP）可能通过旁分泌作用和生长因子释放来改善治疗效果。
对31例对保守治疗六周以上无反应的慢性伤口患者进行了一项前瞻性观察研究。采用临床和照片评估来监测伤口愈合情况。所有患者均接受手术清创，并根据需要采用辅助干预措施——负压伤口治疗、植皮或皮瓣移植。根据伤口特征进行PRP浸润和/或自体脂肪组织转移。伤口面积缩小是主要的结局指标。
该队列包括17名男性和14名女性（平均年龄：59岁）。病因包括静脉功能不全（39%）、糖尿病（25%）、动脉功能不全（16%）和创伤（16%）。大多数伤口（84%）位于下肢。所有患者均接受了PRP治疗；5例接受了PRP和脂肪移植联合治疗。在研究期间，64%的患者伤口面积缩小>80%，48.3%的患者完全愈合，平均愈合时间为49天。PRP治疗被证明是一种安全、有效且适应性强的治疗方法，可促进慢性伤口的大量愈合。自体脂肪组织转移并未带来额外益处。PRP可能值得纳入国家治疗方案。
