Therapeuic Effects And Clinical Applications Of PRP In Chronic Wound

ObjectiveThe purpose of this single-center prospective clinical trial was to investigate the therapeutic effects of Platelet Rich Plasma(PRP)on chronic wounds.MethodsFrom January 2020 to December 2021,according to inclusion and exclusion criteria,chronic wound patients admitted to the Burn and Plastic Surgery Department of the First Affiliated Hospital of Suzhou University were selected.Utilizing a random number table method,patients were divided into the observation group and the control group.In the observation group,autologous venous blood was extracted and PRP was prepared by the double-centrifugation method.The PRP was subsequently mixed with thrombin lyophilized powder to create PRP gel,applied thoroughly to the cleaned wound surface,and ensured complete contact.A foam dressing(12.5cm*12.5cm,KANG LE BAO INTERNATIONAL CO,LIMITED)was used to cover the wound.The control group was treated using the traditional method of the institution,with sterile Vaseline gauze applied after thorough wound cleaning,and foam dressing(12.5cm*12.5cm,KANG LE BAO INTERNATIONAL CO.,LIMITED)as an outer layer.The healing rate,bacterial culture positivity rate,White Blood Cell(WBC)count,C-reactive Protein(CPR)levels,inflammatory cytokines within wound tissue(IL-6 and TNF-α),dressing change frequency,inner dressing replacement frequency,treatment cost,and pain score were compared and assessed to evaluate the efficacy of PRP in treating chronic wounds.Statistical analysis was performed using t-tests for normally distributed data,and Chi-square tests for bacterial culture positivity rates.Results(1).Basic Parameters:The observation group consisted of 21 patients(9 males,12females),age ranging from 51.0-79.0 years,with an average age of(63.28±8.06)years.Wound location included the lower limbs(7 cases),feet(7 cases),sacrococcygeal area(6 cases),and trunk(1 case).Chronic wound etiology comprised vascular ulcers(7cases),diabetic(7 cases),pressure ulcers(6 cases),and traumatic(1 case),with an average wound area of(23.36±12.89)cm~2.The control group consisted of 24 patients(16 males,8 females),age ranging from 50.0-88.0 years,with an average age of(62.91±13.24)years.Wound locations were similar,with etiology including vascular ulcers(7 cases),diabetic(9 cases),pressure ulcers(6 cases),and traumatic(2 cases),with an average wound area of(21.09±12.69)cm~2.No statistically significant differences were found between the observation and control groups for all basic parameters(p>0.05).(2).Wound Healing Rate:At 14,21,and 28 days after the enrollment,the observation group displayed a significantly higher wound healing rate than the control group[(48.95±6.71)%VS(21.29±4.26)%,(79.33±6.96)%VS(46.10±1.97)%,(89.47±7.03)%VS(56.80±2.20)%;p<0.05].(3).Bacterial Culture Positivity Rate:The observation group’s bacterial culture positivity rate was(9.52%,2/21),compared to that of the control group(37.5%,9/24),revealing a significantly lower bacterial culture positivity rate in the observation group(χ~2=0.02,p<0.05).(4)Venous Blood WBC Concentration:Prior to the treatment,the observation group’s WBC concentration was(12.15±2.17)10~9/L,and the control group’s concentration was(12.22±2.40)10~9/L,with no significant difference(p>0.05).After 7days of treatment,the observation group’s concentration significantly decreased to(8.37±2.11)10~9/L,compared to that of the control group(9.46±2.34)10~9/L(t=14.29,p<0.05).After 14 days,it further reduced to(6.64±1.50)10~9/L,significantly lower than that of the control group(8.93±2.01)10~9/L(t=13.04,p<0.05).(5)Venous Blood CRP Concentration:Prior to the treatment,the observation and control groups had CRP concentrations of(5.30±1.41)mg/L and(5.97±1.11)mg/L,respectively,with no significant difference(p>0.05).After 7 days,the observation group’s concentration significantly dropped to(2.92±0.92)mg/L,compared to the control group’s(3.96±1.99)mg/L(t=16.19,p<0.05).After 14 days,it further reduced to 2.64±1.17)mg/L,significantly lower than that of the control group(3.93±1.08)mg/L(t=14.04,p<0.05).(6)Wound Tissue IL-6 Concentration:Initially,the observation and control groups had IL-6 concentrations of(173.76±31.53)ng/kg and(185.13±34.30)ng/kg,respectively,without significant difference(p>0.05).After 7 days,IL-6 concentration of the observation group decreased to(83.39±40.97)ng/kg,significantly lower than that of the control group(137.57±21.65)ng/kg;(t=10.35,p<0.05).After 14 days,IL-6concentration further reduced to(77.47±11.05)ng/kg,significantly lower than that of the control group(137.69±34.17)ng/kg;(t=7.72 p<0.05).(7)Wound Tissue TNF-αConcentration:prior to the treatment,both groups had no significant difference in TNF-αconcentration:observation group(138.30±34.60)ng/kg,control group(145.99±34.06)ng/kg(p>0.05).After 7 and 14 days,the observation group’s TNF-αconcentrations were(70.92±10.10)ng/kg and(68.64±9.80)ng/kg,significantly lower than those of the control group(123.96±15.81)ng/kg;(t=13.19,p<0.05)and(105.93±12.45)ng/kg;(t=11.04,p<0.05),respectively.(8)Number of Dressing Changes:Observation group(15.29±3.50)times,control group(22.95±5.03)times,significantly fewer in the observation group(t=5.85,p<0.05).(9)Number of Inner Dressing Replacements:Observation group(6.19±2.85)times,control group(22.95±5.03)times,significantly fewer in the observation group(t=10.87,p<0.05).(10)Treatment Cost:Observation group(23083.93±5717.52)yuan,control group(23841.75±10930)yuan,no significant difference in treatment cost between the two groups(t=0.13,p>0.05).(11)Visual Analog Scale Score:After 7 days of treatment,the observation group scored(3.23±0.70),significantly lower than that of the control group(5.04±1.16)(t=6.19,p<0.05).ConclusionThe application of Platelet Rich Plasma(PRP)in the treatment of chronic wounds effectively enhances wound healing rate,shortens wound healing time,reduces infection rate,minimizes systemic and local inflammatory responses,decreases dressing change frequency,and alleviates dressing change pain.It is a novel choice for the treatment of chronic wounds.