Application Of Adipose-Derived Mesenchymal Stem Cell Lysate In The Treatment Of Refractory Wounds

Objective: The refractory wound has the characteristics of high treatment difficulty,high treatment cost and long treatment period,so it is the focus of research in the field of wound repair.Therefore,this study aimed to investigate the clinical effects of adipose-derived mesenchymal stem cell lysate in the treatment of refractory wounds.Methods: A total of 124 patients admitted to the Pingyi County People's Hospital from December 2017 to October 2018 were enrolled in the study.The randomized digital table method was used to divide the patients into experimental and control groups,with 62 cases in each group.The two groups of patients were given the same routine treatment of anti-inflammatory and antibacterial.At the same time,with the approval of the ethics committee of the hospital,the experimental group was treated with the infiltration and application of fat mesenchymal stem cell lysate on the wound surface,while the control group was treated with the infiltration and application of normal saline.Then,the total effective rate after 20 days of treatment,the extent of wound reduction after 7 days of treatment and the incidence of adverse reactions after 20 days of treatment were compared.Granulation tissue of patients with wound hyperplasia was taken and ELISA method was used to monitor transformation factor(TGF-beta 1),connective tissue factor(CTGF),vascular endothelial factor(VEGF)and tumor necrosis factor(TNF-alpha).Blood samples were taken from the patients,and the c-reactive protein(CRP)pairs and IgG,IgA and IgM were determined by immune-scattering turbidimetry.Results:(1)According to the pathological evaluation criteria of wound healing,the therapeutic efficiency of the two groups was evaluated.The results showed that the effective rate of the control group was 82.26%,and the effective rate of the experimental group was 96.77%.The wound healing was significantly better than the control group,and the difference was statistically significant(P<0.05).(2)After 7 days of treatment,the wound reduction of the experimental group and the control group were 22.11% and 15.14%,respectively,and the experimental group was significantly higher than the control group(P<0.05).After 20 days of treatment,the wound reduction of the experimental group and the control group were 63.43% and 42.35%,respectively,and the experimental group was significantly higher than the control group(P<0.05).(3)The incidence of adverse reactions in the control group and the experimental group were 14.52% and 1.61%,respectively,Compared with the control group,the experimental group had a lower incidence of adverse reactions,and the difference was statistically significant(P<0.05).(4)Compared with two groups before treatment(P<0.05),there were no significant differences in TNF-? and CRP.The inflammatory factors decreased after 7 days' and 20 days' treatment,but the decline of the experimental group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).(5)Before treatment,there was no significant difference in TGF-? 1,CTGF and VEGF between the two groups(P<0.05),which was comparable.Compared with before treatment,the growth factors of the two groups were significantly higher than those after 7 days' and 20 days' treatment(P<0.05).At the same time,as the treatment time is extended,the treatment effect is also significantly improved.(6)Compared with before treatment,the IgG,IgA and IgM increased significantly after treatment,which was higher than before treatment and the difference was statistically significant(P<0.05).At the same time,compared with the control group,the increase of the experimental group was higher after 7 days of treatment and 20 days after treatment,and the difference was statistically significant(P<0.05).Conclusion: After treatment of refractory wounds with adipose-derived mesenchymal stem cell lysate,local tissue and serological examinations have shown that they have better therapeutic effects,which can not only reduce the wound surface,but also reduce the incidence of adverse reactions.It can reduce inflammatory factors and increase growth factors and immune factors,so it is worthy of application and promotion.