Treatment Effect Analysis Of Platelet-rich Plasma（PRP） Combined With Autologously Micrografting In The Patients Of Refractory Wounds

Objective To observe the feasibility of platelet-rich plasma（PRP）and autologous microskin transplantation and evaluate the clinical efficacy of platelet-rich plasma（PRP）and autologous microskin transplantation in the treatment of refractory woundsMethods The 32 refractory wounds treated in our hospital from August 2017 to December 2018 were selected,and the 32 patients were randomly divided into control group（15）and observation group（17）according to the different wound treatment methods.Control group wounds were treated by the PRP method,and the observed group wounds were treated with PRP combined with the autologous microgranular skin transplantation method.Both groups were treated by debridement,dressing change,antiinfection,and negative pressure drainage.The course was from January to February,and the wound did not heal,but no significant necrotic tissue residue or infection,good granulation tissue growth,and no large area of bone and tendon exposure.Control patients were coagulation with PRP glue cover the wound,or fill the cavity,sinus canal,then covered with polyurethane foam dressing,bandaged and fixed.In the observation group,the thigh was first taken as the skin supply area,and the blade thickness skin was taken about1:4～1:8 according to the supply ratio.The blade thickness skin was prepared into microskin and evenly transplanted into the wound.Then then the wound was covered with PRP gel,and finally treated with polyurethane foam dressing,bandaged and fixed.The two groups underwent the first drug change on day 6 after surgery,followed by drug change observation once on 3 days for 2 consecutive weeks and follow-up for 5-7 months.The wound healing time of the two groups was observed and recorded;the number of patients in the observed and control groups in week 4,and temperature was applied In the Columbia scar assessment scale,the scar growth and score after wound healing in the observation and control groups;the healing time of the skin area and the scar formation in the later followup were recorded.Collect data were processed using SPSS20.0 statistical software,data were t-test,2 test.Results The mean healing time of the observation group wound（17.2 ± 6.1）d,significantly shorter than that of the control group（25.9 ± 11.6）d,was statistically significant（p <0.05）.In May after the operation,the Vancouver Scar Assessment Scale score（5.5 ± 1.3）in the observation group,lower than the control group（8.1 ± 2.26）,was statistically significant（p <0.05）.The wound healing rate of the observed group was 94.10%,60%,higher than that of the control group,which was statistically significant（p <0.05）.The wound of the skin supply area healed within 1 week without obvious scar shape accomplish.Conclusions PRP combined with autologous microskin graft has good clinical efficacy for difficult wounds,which can shorten the wound healing time,improves wound healing rate and improves healing quality compared with PRP alone.PRP in combination with autologous microparticle skin transplantation treatment is a new and feasible combination of treatment methods,easy to operate,obvious effect,and in line with the current treatment concept and ideas of difficult healing wound,which is worth promotion and application in clinical practice.