The application of platelet-rich plasma in the treatment of deep dermal burns: A randomized, double-blind, intra-patient controlled study
The application of platelet-rich plasma in the treatment of deep dermal burns: A randomized, double-blind, intra-patient controlled study
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DOI：
10.1111/wrr.12443
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发表时间：
2016-07-01
影响因子：
2.9
通讯作者：
Middelkoop, Esther
中科院分区：
文献类型：
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作者：
Marck, Roos E.;Gardien, Kim L. M.;Middelkoop, Esther
富血小板血浆（PRP）是血小板浓度高于基线的血液组分。当血小板被激活时，参与伤口愈合的生长因子被释放。PRP在创面护理中的应用已显示出良好的效果，然而，迄今为止，尚未对PRP在烧伤治疗中的作用进行实质性研究。这项随机双盲患者内对照研究调查了自体PRP对需要网状劈裂皮片（SSG）手术的烧伤伤口愈合的影响。在知情同意后，纳入了52例接受SSG手术的不同面积的深真皮至全层烧伤患者。指定可比研究区域A和B（患者内），随机分配，并接受SSG和PRP或单独使用SSG治疗。术后第5 ~ 7天观察上皮化情况和移植物成活率。术后3个月、6个月和12个月，以POSAS问卷、皮肤光谱仪和皮肤测量仪测量的形式进行随访测量。在PRP处理和对照区域之间，第5-7天的平均摄取率和平均上皮形成率之间没有统计学显著差异。然而，PRP治疗的伤口区域在第5-7天比标准治疗区域更常显示更好或相等的上皮形成和吸收率。在再次手术和早期手术亚组中也观察到轻微影响。术后3、6和12个月时，患者和观察者的POSAS评分、Dermaspectro和Cutometer测量值未显示PRP和标准治疗区域之间存在显著差异。总之，在烧伤创面治疗中加入PRP并不能改善移植物的吸收和上皮形成，我们也不能证明更好的瘢痕质量。然而，在我们的临床人群中存在相当大的差异。
Platelet-rich plasma (PRP) is a fraction of blood with a platelet concentration above baseline. When platelets get activated, growth factors involved in wound healing are released. The application of PRP has shown good results in wound care, however, up to date no substantial research has been performed on the effect of PRP in burn treatment. This randomized double blind intra-patient controlled study investigates the effect of autologous PRP on wound healing in burns that require surgery with a meshed split skin graft (SSG). Fifty-two patients with various areas of deep dermal to full thickness burns, receiving surgery with a SSG were included after informed consent. Comparable study areas A and B (intra-patient) were appointed, randomized and either treated with a SSG and PRP or with a SSG alone. At day 5 to 7 postoperative, the epithelialization and graft take rate were assessed. Three, six, and twelve months postoperative, follow-up measurements were performed in the form of POSAS-questionnaires, DermoSpectroMeter, and Cutometer measurements. There was no statistically significant difference between the mean take rate nor the mean epithelialization rate at day 5-7 between the PRP-treated and control areas. However, PRP-treated wound areas showed more often better or equal epithelialization and take rates at day 5-7 than the standard treated areas. Minor effects were also seen in the reoperated and early operated subgroups. At 3, 6, and 12 months postoperative, POSAS scores from the patients and the observers, Dermaspectro-, and Cutometer measurements did not depict a significant difference between the PRP and standard treated areas. Concluding, the addition of PRP in the treatment of burn wounds did not result in improved graft take and epithelialization, nor could we demonstrate better scar quality. There was, however, a considerable variation in our clinical population.