| Objective A deficiency of endogenous epidermal growth factor could lead to delayed wound healing and nonunion.Autologous platelet-rich fibrin(PRF)contains many growth factors.The objective of this experiment is to observe the therapeutic effect of platelet-rich fibrin on diabetic ulcer wounds.The platelet-rich fibrin is applied to the animal model of diabetic ulcers and is then analyzed and compared to the curative effect of the diabetic ulcer through animal models in rabbits.In the latter stage,we will repair the refractory ulcers with the platelet-rich fibrin to analyze the clinical efficacy and feasibility of platelet rich fibrin in the treatment of these ulcers.Methods Animal experimental study:20 white rabbits were randomly divided into a blank control group(4),diabetic model group(4),Recombinant Human Epidermal Growth Factor Gel(rh EGF)group(4),and PRF group(8).The diabetic model group,rh EGF group and PRF group were established into a diabetic animal model.The wounds of the four groups were respectively handled by 1% iodine wound debridement,1% iodophor debridement,rh EGF application,and PRF application.The changes of the wound area and volume were observed in each group.The morphology of the wound was observed by HE staining.The vascular endothelial growth factor(VEGF)protein was detected by immunohistochemical staining,and the mean optical density(MOD)of VEGF was calculated.Clinical application of platelet-rich fibrin:18 patients were collected with refractory ulcers from the First Affiliated Hospital of Medical University Of Anhui,between December 2015 to January 2017.The patients were divided into a PRF treatment group and a traditional group.The two groups were compared before treatment and after treatment for the following categories: in general,healing time,antibiotic use time,hospitalization time,dressing change times,cure rate and recurrence rate differences.Results Animal experimental study: After 3 and 7 days,the intervention found that the ulcer area and the volume of the ulcer skin of the PRF group was smaller than the blank control group or diabetic model group(P< 0.05).At 2 and 3 weeks,through gross pathological observation,the wound surface of rh EGF group and PRF group were covered with a complete skin covering,the dermis was dense,the structure of the skin was(basically-not a very professional word,choose another like essentially)normal,and there was a large number of capillaries.The VEGF protein content of rh EGF group and PRF group in the tissue was determined by Immunohistochemical examination and was significantly higher than those in the blank control group and diabetic model group(P< 0.05).Clinical application of platelet-rich fibrin:Regarding the patients in the PRF group and conventional therapy group,the ulcer healing time,antibiotic use time,hospitalization time,and dressing change times between the two groups are different.The statistical results were statistically significant(P < 0.05);The ulcer recurrence rate of PRF group was lower than the conventional treatment group.However,there was no significant difference between the two groups on cure rate(P > 0.05).Conclusions PRF can significantly promote healing of diabetic skin ulcers,shorten the treatment time,convenience,safety,and economy,comparing with the traditional dressing treatment.Also,it provides new ideas and new methods for the clinical treatment of refractory ulcers. |
