Treatment of chronic refractory wounds with negative pressure wound therapy and platelet-rich plasma: accelerating the re-epithelialization of wounds and increasing

doi:10.3969/j.issn.2095-4344.1357

Abstract

Abstract:

BACKGROUND: Negative pressure wound therapy has been proven to be an effective method to accelerate the healing of various acute and chronic wounds. Platelet-rich plasma is a biotechnology used to stimulate and accelerate tissue healing.

OBJECTIVE: To investigate the clinical efficacy of negative pressure wound therapy in combination with platelet-rich plasma versus simple negative pressure wound therapy in the treatment of chronic refractory wounds.

METHODS: This study was approved by Ethics Committee of the North China University of Science and Technology Affiliated Hospital, China. All included patients or their legal gardian signed informed consent. Fifty patients with chronic refractory wounds were randomly divided into a control group (n=25) and a combined treatment group (n=25). After surgical debridement, patients in the control group received negative pressure wound therapy. In the combined treatment group, after surgical debridement, platelet-rich plasma gel was used to cover the wounds and then negative pressure wound therapy was performed. The negative pressure values of the two groups were set at -9.31 to -39.9 kPa. The treatment was continued with a suction mode. Dressing was changed once a week. Skin grafting was performed according to the wound healing condition. Bacterial culture results, leukocyte and C-reactive protein levels, and erythrocyte sedimentation rate were recorded before and at 7 and 14 days of treatment. Bacterial negative conversion rate, NRS pain score, time required for the second stage repair operation, wound healing time, and length of hospital stay were compared between combined treatment and control groups.

RESULTS AND CONCLUSION: There was no significant difference in the levels of inflammatory factors between the two groups at 7 days after treatment (P > 0.05). The levels of various inflammatory factors, bacterial negative conversion rate and infection control time in the combined treatment group were significantly lower than those in the control group at 14 days after treatment (P < 0.05). The NRS pain score showed a downward trend with treatment time in both groups (P < 0.05). At 14 days after treatment, the NRS pain score in the combined treatment group was significantly lower than that in the control group (P < 0.05). The time required for the second stage repair operation, wound healing time, and length of hospital stay in the combined treatment group were significantly shorter than those in the control group (P < 0.05). All patients were followed up for 1 to 3 months after discharge. Wounds did not recur during the follow up. These results suggest that negative pressure wound therapy in combination with platelet-rich plasma gel exhibits better antibacterial effects than simple negative pressure wound therapy in the treatment of chronic refractory wounds, can effectively shorten wound bed preparation time and wound healing time, accelerate the re-epithelialization of wounds, increase wound healing rate, and relieve pain in the patients.

Key words: platelet-rich plasma, negative pressure wound therapy, chronic refractory wounds, growth factor

CLC Number:

Yang Biao,Wang Shan, Zhang Yan, Liang Chunyu. Treatment of chronic refractory wounds with negative pressure wound therapy and platelet-rich plasma: accelerating the re-epithelialization of wounds and increasing[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(26): 4181-4186.

Figures/Tables 6

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