Autologous Platelet-rich Gel In The Treatment Of Diabetic Ulcer Research

Objective: Diabetic ulcer is one of the main complications of diabetes,and its lack of growth factors makes the wound difficult to heal.Platelet-rich gels are rich in a variety of growth factors and cytokines,which may be similar to natural wound healing processes.In this study,the efficacy of platelet-rich gel treatment for refractory treatment was observed through animal experiments and clinical trials.Among them,the animal experiment established the diabetic rabbit ulcer model and applied the platelet-rich gel to treat the diabetic ulcer.The clinical trial used platelet-rich gel in the repair of clinical refractory ulcer wounds,and its safety and clinical effectiveness.A systematic review was made and compared to standard therapies.Method:(1)Animal Experimental Study Twenty-four New Zealand rabbits were established with a diabetic ulcer wound model.One wound was made on each side of the back spine of each rabbit,which was labeled as APG treatment wound and conventional dressing treatment.The changes of wound area were observed in each group.The specimens were fixed at 1 week and 2 weekends,and the vascular endothelial growth factor(VEGF)protein and insulin-like growth factor(IGF)protein were labeled with immunohistochemistry.The Image Plus Pro 6.0 image analysis system calculates the average optical density of VEGF and IGF.(2)48 patients with diabetic ulcer were randomly divided into two groups,one group was APG treatment group(25 cases),and one group was conventional dressing control group(23 cases).The sinus closure time,ulcer healing rate,hospital stay,and hospitalization costs were compared between the two groups.Results:(1)The healing rate of the wound in the experimental group was significantly higher than that in the blank control group.At 1 week and 2 weekends,the positive ratesof VEGF and IGF in the APG treatment group were significantly different from those in the blank control group.At 1 week and 2 weekends,the average photoprotein density of VEGF and IGF in the APG treatment group was higher than that in the control group(P<0.05,the difference was statistically significant).(2)The healing rate of APG treatment group was significantly improved,96% of APG group healed completely,and87% of the control group healed completely.In the first 4 weeks,the sinus healing rate of the APG group was significantly higher than that of the control group.There was no significant difference in sinus healing between the two groups at the end of week 8.The average hospital stay in the APG group and the control group were 19.36 ±7.239 days and 48.13 ±11.721 days,respectively.The total hospitalization expenses were(2.48± 0.45)yuan and(5.63 ± 1.35)yuan(p < 0.05).These differences are statistically significant.Conclusions: Having with traditional dressing changes,APG can accelerate the healing of deep sinus wounds associated with diabetic ulcers.There were no adverse reactions in the APG experimental group.Through APG treatment,the healing period of these clinically difficult-to-heal wounds is shortened,Which can significantly reduce patient pain,shorten hospital stay and reduce scar tissue formation.