Clinical Study Of Injectable Platelet Rich Fibrin Combined With Allogeneic Skin In The Treatment Of Deep Second Degree Burn Wounds

Objective:To explore the clinical efficacy of injectable platelet-rich fibrin combined with allogeneic skin in the treatment of deep second degree burn wounds,so as to provide a better method for the treatment of deep second degree burn wounds.Method:In this study,64 patients with deep second degree burn treated in the Burn plastic surgery Department of Nantong Hospital from 2021.June to 2022.August were included in this prospective study.All the patients were informed of the research purpose and related risks.They were enrolled in groups A,B,C and D by random number method with the cooperation of their families and signed informed consent.All the wounds by debridement,the group A was covered with Vaseline gauze,the group B was treated with i-PRF and covered with Vaseline gauze,the group C was covered with allogeneic skin,the D group was injected with i-PRF and covered with allogeneic skin.Then set sterilized dressing on the wound.The dressing was changed for the first time 7days after operation,and then changed every 2 days.The wound healing time,wound healing rate,degree of inflammation,severity of pain,hypertrophic scar formation and safety indexes were compared and analyzed among the four groups.Result:1.Baseline data: This trial ended up with 64 patients who met the requirements of the trial and had complete follow-up information,16 patients in each of the four groups A,B,C and D.There was no difference in age,sex,total burn area and test area among the four groups(P < 0.05).2.Wound healing time: group A > group B > group C >group D.The difference between the two groups was significant(P < 0.05).3.Wound healing rate: Intra-group comparison: there was significant difference among the four groups on the days 10,13 and 16 after operation(P < 0.05).Intergroup comparison: on the days 10,13 and 16 after operation,the healing rate in group D was higher than group A,B and C(P< 0.05).The healing rate in group B and C was higher than group A(P < 0.05),and there was no difference between group B and group C.4.The degree of wound inflammation: Intra-group comparison: there was significant difference between the four groups on the day 7,10 and 13 after operation(P< 0.05).Intergroup comparison: On the day 7 after operation,there were significant differences among the four groups(P < 0.05).On the days 10 and 13 after operation,the degree of inflammatory response in group D was significantly lower than that in group A,B and C(P < 0.05),and group B and C was significantly lower than that in group A(P < 0.05),while the differences between groups B and C were not significant.5.VSA score: Intra-group comparison: There were differences among the four groups on the day 1,2 and 3 after operation(P < 0.05).Intergroup comparison: On the first day after operation,the group B was lower than group A,B and C(P < 0.05),and the group B and C was lower than group A(P < 0.05),but there was no significant difference between group B and group C.On the second and third day after operation,the group D was lower than group A(P < 0.05).There was no significant difference among other groups.6.VSS scores: Intra-group comparison: There was no difference in group B,C and D at 3 and 6 months after wound healing,but there was significant difference in group A(P < 0.05).Intergroup comparison: at 3 and 6 months after wound healing,the group D was lower than groups A,B and D(P < 0.05),and the group B and C was lower than group A(P < 0.05).There was no significant difference between group B and group C.7.Safety indexes: There was no significant difference in blood routine,CRP,liver and kidney function among the four groups on the day 3 after operation(P>0.05).Pulse,blood pressure,respiration and body temperature fluctuated within the normal range over the course of hospitalization in the four groups,and no serious adverse reactions such as systemic allergy,shock and poisoning occurred.Conclusion:Injectable platelet-rich fibrin combined with allogeneic skin is safe in the treatment of deep second degree burn wounds,which can reduce wound inflammatory reaction,relieve wound pain,accelerate wound healing and reduce scar hyperplasia.