Clinical Application Of Advanced Platelet-rich Fibrin In Donor Site Wounds Of Medium Thickness Skin Graft

Background Scholars such as Ghanaati used lower speed and centrifuged peripheral whole blood without additives in 2014 to prepare a new generation of platelet concentrate containing more leukocytes and advanced platelet-rich fibrin(A-PRF).It has the effect of promoting tissue repair and has been widely used in the field of tissue repair.For acute and chronic wounds caused by a variety of pathogenic factors,skin grafts are often used clinically to repair them.Medium-thickness skin grafts are widely used in wound repair due to their rich skin sources and high survival rate.However,due to the deep wound of the medium-thickness skin donor site and the dermis,the healing time is longer and the appearance and function of the scar healing are affected,which brings inconvenience to life.The author’s research aims to observe the therapeutic effect of A-PRF on the wounds of the medium-thick skin graft donor site through clinical application,and confirm that A-PRF can promote the healing of the medium-thick skin graft donor site wounds and reduce postoperative pain and scar hyperplasia.It provides new ideas and methods for clinicians to choose biomaterials that promote the healing and regeneration of soft tissues in the donor site of medium-thickness skin grafts.Methods According to the inclusion and exclusion criteria,80 patients in the Plastic Surgery Department of the Second Affiliated Hospital of Anhui Medical University who needed medium-thickness skin grafts to repair their wounds from January to October 2019 were selected and randomly divided into 4 groups A,B,C,and D.A-PRF membrane(group A),platelet-rich fibrin(PRF)membrane(group B),and recombinant bovine basic fibroblast growth factor gel(C Group)and the blank control group(Group D).The wounds of the donor sites in the 4 groups were covered with Vaseline gauze and pressure-wrapped with sterile gauze.The wound healing time of the skin donor site in the 4 groups was recorded,and the visual analog scale(VAS)was used to evaluate the medium-thickness skin donor site wounds at 24 hours,7 days,10 days and 14 days postoperatively in each group.Pain,according to the Vancouver Scar Scale(Vancouver Scar Scale,VSS)to evaluate the scars of each group at the 3rd and 6th months after surgery.Results(1)Postoperative pain: The VAS scores of the four groups on the first 1,7,10,and 14 days after the operation were all group A <group B <group C <group D,and the difference between the four groups was statistically significant(P> 0.05).There were statistically significant differences between A-PRF and the other 3 groups in the four time periods(P> 0.05).(2)Healing time: Healing time of four groups: A group <B group <C group <D group,there are statistically significant differences between any two groups(P <0.05).(3)Postoperative scars: The VSS scores in the 3rd and 6th months after the operation were both in group A <group B <group C <group D,and the difference was statistically significant(P <0.05).Pairwise comparison between groups:A and There were statistically significant differences in VSS scores in the three groups B,C,and D at the 3rd and 6th month after surgery(P<0.05).Conclusion A-PRF can reduce postoperative pain,accelerate the healing of mediumthick skin donor site wounds,reduce scar hyperplasia,and improve the postoperative morphology.