Clinical Research Of The Platelet-rich Plasma In The Treatment Of Dermal Chronic Ulcer Wound

Objective(s):The treatment of complex and intractable wounds is a difficult problem in the surgical field.Platelet rich plasma(PRP)can repair and reconstruct the wound surface by releasing growth factors after activation,thus achieving the purpose of healing wound surface.The purpose of this study was to investigate the clinical effect of platelet-rich plasma(PRP)in the treatment of chronic refractory wounds.To explore the pathophysiological mechanism of platelet-rich plasma in the treatment of chronic refractory wounds.Methods:Fifty-two patients with chronic refractory wounds caused by trauma,pressure sores,diabetes and vasculitis in the 920 Hospital of the Joint Logic Support Force of the Chinese People’s Liberation Army from December 2019 to November 2020 were selected as the research subjects.They were divided into two groups,including 20 cases in the control group and 32 cases in the experimental group.All patients received outpatient surgery for complete debridement,and the experimental group was given PRP to cover the wound after debridement,and the PRP was changed once every 3 days,4 times as a course of treatment.The control group underwent routine dressing change after surgery,and skin grafting or flap transfer was selected according to the wound healing situation to accelerate the wound healing.The wound healing effect of the two groups was observed 1 month later.Elase kit was used to evaluate platelet-derived growth factorPDGF,Transforming growth factor β(TGF-β),Epidermal growth factor EGF,and Vascular endothelial growth factor(Vascular endothelial growth factor)in the two groups of woundsVEGF and insulin-like growth factors(IGFs)were determined and analyzed statistically.VAS score,times of dressing change,length of hospital stay and treatment cost of the two groups were counted and compared respectively.Results:All patients received complete follow-up.Statistics showed that 32 patients in the experimental group received healing under the scab after 2 to 4 times of PRP gel treatment,with an average of 5.09 times of dressing change and an average of 25.26 days of complete wound healing.In the control group,16 cases healed after routine dressing change,3 cases healed after skin grafting,and 1 case healed after pedicled skin flap transfer.The mean dressing change was 24.7 times,and the mean time of complete wound healing was 42.95 days.Treatment group in the process of VAS score treatment,cost is significantly lower than the control group,the difference was statistically significant(P<0.05),the experimental group within the wound transforming growth factor beta,epidermal growth factor,vascular endothelial growth factor,insulin-like growth factor concentration significantly higher than the control group,the difference was statistically significant(P<0.05).Conclusion(s):Compared with the traditional treatment,PRP by activated long-term slow release of platelet-derived growth factor,transforming growth factor beta,epidermal growth factor,vascular endothelial growth factor,insulin-like growth factor,etc.,to increase growth factor concentration inside the wound,accelerate wound healing,shorten the treatment time and hospital stay,reduce the cost of treatment,patients relief from pain.In conclusion,PRP can be regarded as an effective method in the treatment of chronic refractory wounds.However,due to the small sample size of this study,the conclusions of this study need to be further confirmed by a large random and prospective sample survey.