The Study Of Treatment Of Traumatic Tendon/extraosseous Injury With PRP Combined With Artificial Dermis And Exposed Wound Surface And Its Effect On Wound Surface Of Model Rats

ObjectiveBy comparing artificial dermis and artificial dermis combined with PRP(platelet-rich plasma)in a randomized controlled experiment to explore the clinical efficacy of PRP combined with artificial dermis in the treatment of deep tendon/bone exposed wounds in acute trauma,and using the SD rat traumatic tendon exposed model to evaluate the wound healing,Wound tissue for pathological observation,to provide the basis and basic experimental evidence for the clinical application of artificial dermis combined with PRP.Methods1.A total of 72 patients who were hospitalized in the Department of Restorative and Reconstructive Surgery in Foshan City and met the traumatic tendon/bone exposed wounds were enrolled according to the inclusion and exclusion criteria and were randomly divided into artificial dermis group and artificial dermis+PRP group(n=36).The control group was treated with artificial dermis + PRP,and the control group was treated with artificial dermis.The vascularization time of the artificial dermis,the wound condition,and BWAT score before the operation,when the silicone membrane was removed,and the wound surface before the operation,when the silicone membrane was removed,and 7 days after skin grafting was observed.Pain,skin graft survival rate,wound healing time,scar score 1 and 3months after skin grafting,and safety of intervention measures.2.Establish a traumatic tendon exposure model in SD rats and randomly divide them into a model group,a dermis group,a PRP group,and a dermis+PRP group,with 8 rats in each group.The model group changed the dressing routinely after modeling,the PRP group and the dermis group changed the dressing after the modeling and intervention measures were the same as the model group,the dermis+PRP group covered the wound with PRP gel before using the artificial dermis,and the rest were the same as the artificial dermis.Leather set.The rats’ wound conditions were observed,the wound tissues were taken at the7 th,10th,and 14 th hour respectively,and the changes in the pathological sections and the collagen growth were observed.ResultsClinical observation part: There was no statistically significant difference between the two groups in comparing baseline indicators such as the cause of injury,injury site,wound area,wound depth,and whether there was bone/tendon exposure.The wound vascularization time,wound healing time,and 10-day survival rate of skin grafting were compared between the two groups,and the differences were statistically significant.There was no statistically significant difference in the VAS scores of the wounds of the two groups before the first-stage operation when the dermal silicone membrane was removed and at 7 days after skin grafting.There was no statistically significant difference before the first-stage operation(P>0.05),but the BWAT score of the wound surface was statistically significant when the dermal silicone membrane was removed(P<0.05);comparing the scar scales of the two groups,there was a significant difference at 1 month after the operation.Statistically significant(P<0.05),and the difference was statistically significant at 2 months after the operation(P<0.05).Animal experiment part: Comparing the wound healing rate of rats in each group at 7,14,and 21 days,the difference was not statistically significant(P>0.05),but the wound healing rate of the dermis + PRP group was significantly accelerated at 14 days,which was comparable to that of the other three groups.In comparison,the wound healing rate was the highest;observing the HE staining of the pathological sections,the number of new blood vessels in the dermis of the wound tissue decreased,the infiltration of inflammatory cells was reduced,the collagen fibers were arranged more closely,and the activity of epithelial cells was more active;compared with Masson staining in each group,the dermis + PRP group The number of collagen fibers is more,and the arrangement is more regular,neat and compact.ConclusionPRP combined with artificial dermis has a better curative effect in the treatment of traumatic tendon exposed wounds and is better than using artificial dermis alone,through the number of new blood vessels in the dermal-like tissue and the content and order of collagen,which provides good wound bed conditions for the survival of the second-stage skin graft.