| ObjectivesThe purpose of this study is to explore the clinical efficacy and application value of injectable platelet-rich fibrin combined with artificial dermis compared with the pure application of artificial dermis in the treatment of chronic refractory wounds.It adds a better method for the treatment of chronic refractory wounds.MethodsA total of 40 patients with chronic refractory wounds admitted to the burn and plastic surgery department of affiliated hospital of Nantong University from August2021 to December 2022 were selected as the study subjects.They were randomly divided into artificial dermis group and i-PRF group(i-PRF combined with artificial dermis)with 20 patients in each group,with an age of 36 to 80 years old.In the artificial dermis group,ulcers were covered with artificial dermis after wound debridement.in the i-PRF group,used the pre-prepared syringe with i-PRF to obliquely penetrate the wound base and around the wound,with a depth of 2-3mm,and about0.1ml per 1 square centimeter.After the injection,apply appropriate amount of i-PRF on the wound,and then perform artificial dermis transplantation.The two groups of patients were treated with dressing changes after operation,and the wound was repaired when artificial dermis vascularize completely.We compared some observation indicators between the two groups,such as Wound bacterial culture,inflammation index,VAS pain score,the time of artificial dermis vascularization,times of dressing changes,hospital days after operation and cost.We used IBM SPSS Statistics 27 software to analyze the data.Results(1)Wound bacterial culture: In the artificial dermis group,there were 13 cases of positive bacterial culture on the wound surface before operation(before artificial dermis transplantation),and 8 cases of positive bacterial culture 7 days after operation(after artificial dermis transplantation),with a negative conversion rate of 38.46 %.In the i-PRF combined treatment group,there were14 cases of positive bacterial culture on the wound surface before operation,and3 cases of positive bacterial culture 7 days after operation,with a negative conversion rate of 78.57%.There was significant difference in the results of wound bacterial culture between the two groups on the 7th day after operation(P<0.05).(2)Inflammation index: There was no statistically significant difference in leukocyte,C-reactive protein and procalcitonin indexes between the two groups before operation(P>0.05),which was comparable.The inflammatory index of the two groups showed a downward trend on the 6th and 12 th day after operation.Test time effect separately,the difference between the two groups was statistically significant(P<0.05).Test grouping effect separately,the inflammatory index in the i-PRF group was lower than that in the artificial dermis group(P<0.05),excepting for the difference of procalcitonin on the 12 th day after operation was not obvious.(3)VAS pain score: There was no significant difference in VAS pain score between the two groups at before operation(P>0.05).The VAS pain score of patients in the two groups showed a downward trend on the 3th、6th and 9th day after operation.The VAS pain score in the i-PRF group was lower than that in the artificial dermis group,with a statistically significant difference(P<0.05).(4)the time of artificial dermis vascularization: the time of artificial dermis vascularization in the i-PRF group was shorter than that in the artificial dermis group,and the difference was statistically significant(p<0.05).(5)The times of dressing changes: the times of dressing changes in the i-PRF group was less than that in the artificial dermis group,and the difference was statistically significant(p<0.05).(6)The hospital days after operation and cost: The hospital days after operation and cost in the i-PRF group were less than that in the artificial dermis group,and the difference was statistically significant(p<0.05).ConclusionCompared with artificial dermis alone in the treatment of chronic refractory wounds,i-PRF combined with artificial dermis has advantages in reducing bacterial colonization,controlling inflammation,alleviating wound pain,reducing the times of dressing changes,shortening the vascularization time of artificial dermis,reducing the hospital days and cost after operation,etc.i-PRF combined with artificial dermis has high clinical application value in the treatment of chronic refractory wounds. |
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