| Objective: This study mainly studied the clinical efficacy of platelet-rich plasma(PRP)combined with vacuum sealing drainage(VSD)in the treatment of chronic refractory wounds.And compared the efficacy differences of platelet-rich plasma alone,vacuum sealing drainage alone and platelet-rich plasma combined with vacuum sealing drainage in the treatment of chronic refractory wounds.In order to accelerate the wound healing,improve the cure rate of chronic refractory wounds,relieve the pain and economic burden of patients,and provide the clinical basis for the treatment of chronic refractory wounds.Methods:(1)A total of 72 patients with chronic refractory wounds admitted to the Department of Burn Plastic Surgery and Wounding Repair of the Affiliated Hospital of Youjiang Medical University for Nationalities from July 2019 to December 2020 were randomly divided into three groups according to the order of admission,with 24 patients in each group: PRP group,VSD group,and combined group.(2)Wound debridement was performed on all patients after admission.The PRP group was treated with local injection of platelet-rich plasma,the VSD group was treated with vacuum sealing drainage,and the combined group was treated with local injection of platelet-rich plasma after 7 days of vacuum sealing drainage.(3)Observation recorded before treatment,treatment for 7 days,14 days after treatment index of three groups of patients with wound infection(white blood cells,CRP level),the positive rate of bacteria,the visual analogue scale(VAS)pain,wound area and preparation time for second stage wound repair,granulation tissue growth,the total effective rate,wound healing of the wound healing quality score(VSS),the total incidence of wound complications,the SPSS22.0 statistical software was used for statistical analysis of the obtained data..Results:(1)Comparison of general basic information: There were 24 patients in PRP group(1 case lost to follow-up,2 cases abandoned midway),24 patients in VSD group(1case lost to follow-up),and 24 patients in combined group(1 case abandoned midway,1 case lost to follow-up).The comparison of general information(age,gender,type of wound,etc.)among the three groups showed that there was no statistical significance(P > 0.05).(2)Comparison of white blood cell and CRP levels:According to the variance results of repeated measurements,there was statistically significant difference in WBC count between groups(F=4.477,P<0.05),and there was statistically significant difference in CRP level between groups(F=4.127,P<0.05).Pair comparison between groups showed that WBC and CRP levels in the combination group on the 7th and 14 th days after treatment were lower than those in the PRP and VSD groups.(3)Comparison of positive rate of bacteria:There was no significant difference in the positive rate of bacteria on wound surface between the three groups before treatment and the 7th day of after treatment(P > 0.05),but there was a significant difference in the positive rate of wound surface on the 14 th day of after treatment(P < 0.05),and the positive rate of combined group was lower than that of PRP group and VSD group.(4)Comparison of visual analogue score of pain: the variance of repeated measurements was obtained,and the difference between groups was statistically significant(F=6.539,P < 0.05),and the pain degree of the combination group on the 7th and 14 th days of after treatment was lower than that of the other groups.(5)Comparison of wound area: The difference between groups was statistically significant(F=773.865,P < 0.05),and pairwise comparison between groups showed that the wound area of the combination group on the 7th and 14 th days of after treatment was significantly lower than that of the PRP group and the VSD group.(6)The difference in the preparation time for second stage wound repair between the three groups was statistically significant(P < 0.05),and the pairwise comparison showed that the wound healing time of the combined group was significantly lower than that of the PRP group and the VSD group.(7)The difference in wound healing quality among the three groups was statistically significant(P < 0.05),and the pairwise comparison showed that the wound healing quality of the combined group was better than that of the PRP group and the VSD group.(8)There were significant differences in the total effective rate of wound healing between the three groups on the 14 th day and the 21 st day of after treatment(P < 0.05),and the total effective rate of wound healing in the combined group was higher than that in the PRP group and the VSD group.(9)There was no statistical significance in the recurrence among the three groups(P > 0.05).Conclusion: Platelet-rich plasma combined with negative pressure sealing drainage in the treatment of chronic refractory wounds can accelerate wound healing,improve the cure rate of chronic refractory wounds,and provide a new choice for the treatment of chronic refractory wounds. |
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