Clinical Effect Of Combined Application Of Concentrated Growth Factor And Plasma Albumin Gel In The Treatment Of Facial Depressed Scar

Background and ObjectiveInjury involving the dermis can cause damage to the normal structure of skin,and the scars may appear.Scars in exposed areas can cause psychological problems such as anxiety and depression.Depressed scars,which mainly manifested as skin depressions,are often caused by loss of tissue or traction beneath the scar,or thinning of the scar itself.Injection is one of the common clinical therapies for the treatment of depressed scars.Platelet-rich plasma(PRP)and platelet-rich fibrin(PRF)have been widely used in clinical treatment as the first and the second generations platelet products,and the third-generation platelet product CGF(concentrated growth-factor)also has good effect in repair.PAG(plasma albumin gel)is a product obtained by heating and coagulating platelet-poor plasma(PPP),and used as a kind of depression filler in burn and plastic surgery departments'treatment.Applying CGF,PAG and their combination to treat depressed scars is rarely reported at home and abroad.This study intends to analyze and compare the efficacy of CGF,PAG and their combination in the treatment of facial depressed scars.MethodsFrom January 2018 to September 2019,30 patients with facial depressed scar who met the selection criteria were admitted in the department of the author.Retrospective analysis of clinical data was done.According to the method of treatment,10 people were included in CGFgroup,PAG group and CGF+PAG group respectively.The patients in the three groups were treated with the same method.Take appropriate amount of CGF,PAG,and CGF mixed with PAG(scale 1.0:1.0)and inject it to the subcutaneously of the patients in corresponding group.The injection volume is appropriate to fill up the depression and slight higher than the skin surface.Treatment was performed once every 4 weeks for three times in total.Before the first treatment and 3 months after the last treatment,Goodman&Baron scar grading system was used for scar grading and the difference was calculated,and anxiety self-rating scale was used to score anxiety and the difference was calculated.Visual analogue score for pain scores was measured in the first time treatment.Sear treatment satisfaction score and global aesthetic improvement scale were performed at the first,second,and the third month after treatment.Post-treatment observation was done in order to detect if there is any adverse reaction and complication.Data were processed with Fisher's exact probability test,one-way analysis of variance,chi-square test,Kruskal-Wallis H test,Mann-Whitney U test,Bonferroni correction,and Wilcoxon signed ranks test.Results1.The scar grades of patients in the CGF group,PAG group,and CGF+PAG group were all 4.00(4.00,4.00)before treatment.Compared with the untreated time,the scar grades of patients in the CGF group,PAG group,and CGF+PAG group were significantly reduced at the third month after treatment(P<0.05),amd the scar grade of PAG group,CGF group,and CGF+PAG group decreased in order.There was statistically significant differences between the difference in the patients'before and after treatment'scar grading in the CGF group,PAG group,and CGF+PAG group(?2=17.145,P<0.001),and there was a statistical difference between each two groups(P<0.05).The scar grading difference between before and after treatment of the PAG group,the CGF group,and the CGF+PAG group were gradually increased.2.The anxiety scores of the three groups in the before and third month after treatment were both similar(P>0.05).Compared with the untreated time,the anxiety scores of patients in the CGF group,PAG group,and CGF+PAG group were significantly reduced at 3 months after treatment(P<0.01),which was significantly lower than that before treatment.There was no significant difference of the difference in anxiety scores of before and after treatment in the overall comparison between the groups.(?2=3.697,P>0.05).3.The pain scores of the three groups were similar immediately at the first-time injection treatment(?2=0.579,P>0.05).4.The first month after treatment,the patients' satisfaction scores of the three groups were similar(P>0.05).At the second and the third month after treatment,there was a statistically significant difference in the satisfaction score of scar treatment among the three groups(P<0.05 or P<0.01).The second month after treatment,the satisfaction score of patients in the CGF+PAG group was higher than PAG group(P<0.0167).The satisfaction scores of patients in the CGF group and the CGF+PAG group were higher than those in the PAG group at the third month after treatment(P<0.0167).For the CGF group patients,the satisfaction scores of patients in the third month after treatment was higher than at the first and the second months after treatment(P<0.05).For the patients in the PAG group and CGF+PAG group,the satisfaction scores increased in order at the first,second,and third month after treatment(P<0.05).5.At the first,second,and third month after treatment,there were significant differences in the scores of scar aesthetic improvement scores of the three groups of patients(P<0.05).At the first month after treatment,the scar aesthetic improvement scores of CGF+PAG group was higher than that in the PAG group(P<0.0167).At the second months after treatment,the sear aesthetic improvement scores of the the CGF and CGF+PAG group were higher than those in PAG group(P<0.0167).At the third month after treatment,the scar aesthetic improvement score of PAG group,CGF group,and CGF+PAG group increased in order(P<0.0167).In the CGF group and the PAG group,the scar aesthetic improvement score in the second and third months after treatment were higher than those in the first month after treatment(P<0.05).In the CGF+PAG group,the scar aesthetic improvement score in the first,second,and third month after treatment were increased in order(P<0.05).6.All the patients in three groups had slight redness and swelling at the needle prick point after injection,and all of them resolved within 30 minutes.ConclusionSingle and combined application of CGF and PAG have different degrees of curative effect on patients with facial depressed scar.Compared with those of single CGF or PAG injection,the combined injection has best effects,and the CGF group has better effect than PAG group.The injection therapy reduces the scar scale and anxiety,increases the patients'satisfaction and the scars'aesthetic improvement scale,and has better effect in the treatment of patients with facial depressed scar.The method is worthy in clinical promotion.