Clinical efficacy of local injection of platelet-rich plasma combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity

Wu Jiamin; Yang Hao; Li Qi; Luo Taofan; Yang Po; Huang Weichen

doi:10.3760/cma.j.cn501225-20230420-00134

Volume 39 Issue 9

Sep. 2023

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2023 > 39(9): 849-856

Wu JM,Yang H,Li Q,et al.Clinical efficacy of local injection of platelet-rich plasma combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity[J].Chin J Burns Wounds,2023,39(9):849-856.DOI: 10.3760/cma.j.cn501225-20230420-00134.

Citation:

PDF( 8585 KB)

Clinical efficacy of local injection of platelet-rich plasma combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity

doi: 10.3760/cma.j.cn501225-20230420-00134

Wu Jiamin^{1, 2
,
,},
Yang Hao²,
Li Qi²,
Luo Taofan²,
Yang Po³,
Huang Weichen³

1.
Department of Burns and Plastic Surgery, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China
2.
Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
3.
Department of Orthopaedic Trauma, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China

More Information

Corresponding author: Wu Jiamin, Email: wujiamin1972@sina.com
Received Date: 2023-04-20

Abstract

Abstract

Objective To investigate the clinical efficacy of local injection of platelet-rich plasma (PRP) combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity. Methods A retrospective observational study was conducted. From December 2017 to October 2022, 16 patients were admitted to Department of Orthopaedic Trauma of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, and 32 patients were admitted to Department of Burns and Plastic Surgery of Guiyang Steel Factory Staff Hospital. All the patients had wounds with exposed tendon on extremity caused by various reasons and met the inclusion criteria. There were 39 males and 9 females, aged 26 to 58 years. The patients were divided into PRP alone group, artificial dermis alone group, and PRP+artificial dermis group, with 16 patients in each group. The wounds were treated with autologous PRP, double-layer artificial dermis, or thei combination of autologous PRP and double-layer artificial dermis, followed by autologous split-thickness scalp grafting after good growth of granulation tissue. On the 7 ^th day after the secondary surgery, the autograft survival was observed, and the survival rate was calculated. The wound healing time and length of hospital stay of patients were recorded. At 3 and 6 months after wound healing, the Vancouver scar scale (VSS) was used to score the pigmentation, height, vascularity, and pliability of scars, and the total score was calculated. Adverse reactions during the entire treatment process were recorded. Data were statistically analyzed with chi-square test, Fisher's exact probability test, one-way analysis of variance, least significant difference test, Kruskal-Wallis H test, Nemenyi test, and Bonferroni correction. Results On the 7 ^th day after the secondary surgery, there was no statistically significant difference in the autograft survival rate of patients among PRP alone group, artificial dermis alone group, and PRP+artificial dermis group ( P>0.05). The wound healing time and length of hospital stay of patients in PRP+artificial dermis group were (20.1±3.0) and (24±4) d, respectively, which were significantly shorter than (24.4±5.5) and (30±8) d in PRP alone group ( P<0.05) and (24.8±4.9) and (32±8) d in artificial dermis alone group ( P<0.05). At 3 and 6 months after wound healing, the pliability scores of patients in PRP+artificial dermis group were significantly lower than those in PRP alone group (with Zvalues of 12.91 and 15.69, respectively, P<0.05) and artificial dermis alone group (with Zvalues of 12.50 and 12.91, respectively, P<0.05). There were no statistically significant differences in pigmentation, vascularity, height scores, and total score of scar of patients among the three groups ( P>0.05). In artificial dermis alone group, one patient experienced partial liquefaction and detachment of the double-layer artificial dermis due to local infection of Staphylococcus epidermidis, which received wound dressing change, second artificial dermis transplantation, and subsequent treatment as before. No adverse reactions occurred in the remaining patients during the whole treatment process. Conclusions Local injection of PRP combined with double-layer artificial dermis is effective in treating wounds with exposed tendon on extremity, which can not only significantly shorten wound healing time and length of hospital stay, but also improve scar pliability after wound healing to some extent in the long term. It is a clinically valuable treatment technique that is worth promoting and applying.
- Platelet-rich plasma,
- Skin transplantation,
- Local injection,
- Double-layer artificial dermis,
- Tendon exposure,
- Wound repair

FullText(HTML)

References(26)

References

[1]	ChouhanD,MandalBB.Silk biomaterials in wound healing and skin regeneration therapeutics: from bench to bedside[J].Acta Biomater,2020,103:24-51.DOI: 10.1016/j.actbio.2019.11.050.
[2]	OuKL,TzengYS,LiuHH,et al.Negative pressure wound therapy in conjunction with artificial dermis for burned hand reconstruction[J].Ann Plast Surg,2021,86(2S Suppl 1):S13-17.DOI: 10.1097/SAP.0000000000002676.
[3]	ZieglerB,HundeshagenG,WarszawskiJ,et al.Implementation and validation of free flaps in acute and reconstructive burn care[J].Medicina (Kaunas),2021,57(7):718.DOI: 10.3390/medicina57070718.
[4]	AlvesR,GrimaltR.A review of platelet-rich plasma: history, biology, mechanism of action, and classification[J].Skin Appendage Disord,2018,4(1):18-24.DOI: 10.1159/000477353.
[5]	PicardF,HersantB,BoscR,et al.The growing evidence for the use of platelet-rich plasma on diabetic chronic wounds: a review and a proposal for a new standard care[J].Wound Repair Regen,2015,23(5):638-643.DOI: 10.1111/wrr.12317.
[6]	杨思思,肖承志.自体富血小板血浆对烧伤创面治疗影响的研究进展[J].中华烧伤杂志,2018,34(12):910-913.DOI: 10.3760/cma.j.issn.1009-2587.2018.12.017.
[7]	中国老年医学学会烧创伤分会.浓缩血小板制品在创面修复中应用的全国专家共识(2020版)[J].中华烧伤杂志,2020,36(11):993-1002.DOI: 10.3760/cma.j.cn501120-20200507-00256.
[8]	邬佳敏,王达利,贺钧,等.难愈创面局部注射自体富血小板血浆临床观察[J].贵州医药,2019,43(5):749-750.DOI: 10.3969/j.issn.1000-744X.2019.05.028.
[9]	李敏雄,马军,郑紫君,等.双层人工真皮复合自体皮移植修复骨质和/或肌腱外露创面的临床疗效[J].中华烧伤杂志,2020,36(3):179-186.DOI: 10.3760/cma.j.cn501120-20191119-00437.
[10]	董其强,谢书强,王礼军,等.负压封闭引流联合Lando®人工真皮并结合自体皮移植应用于手足部骨肌腱外露伴骨折创面的临床研究[J/CD].中华损伤与修复杂志(电子版),2020,15(1):51-55.DOI: 10.3877/cma.j.issn.1673-9450.2020.01.008.
[11]	王磊,蔡玉辉,胡克苏,等.富血小板血浆联合人工真皮/自体超薄皮片治疗难愈性创面[J].南京医科大学学报(自然科学版),2019,39(10):1501-1504.DOI: 10.7655/NYDXBNS20191021.
[12]	孙赫阳,黄剑,杨科跃,等.Masquelet技术联合双层人工真皮在四肢大面积皮肤脱套性缺损中的应用[J].现代实用医学,2021,33(5):631-633.DOI: 10.3969/j.issn.1671-0800.2021.05.033.
[13]	《双层人工真皮临床应用专家共识(2019版)》编写组.双层人工真皮临床应用专家共识(2019版)[J].中华烧伤杂志,2019,35(10):705-711.DOI: 10.3760/cma.j.issn.1009-2587.2019.10.001.
[14]	WangW,ZhangL,SunL,et al.Biocompatibility and Immunotoxicology of the preclinical implantation of a collagen-based artificial dermal regeneration matrix[J].Biomed Environ Sci,2018,31(11):829-842.DOI: 10.3967/bes2018.110.
[15]	陈丹丹,彭新洁,李彦红,等.双层人工皮肤的生物相容性研究[J].中国药事,2013,27(11):1184-1188,1200.
[16]	BloemenM,van LeeuwenM,van VuchtNE,et al.Dermal substitution in acute burns and reconstructive surgery: a 12-year follow-up[J].Plast Reconstr Surg,2010,125(5):1450-1459.DOI: 10.1097/PRS.0b013e3181d62b08.
[17]	ShahrokhiS,ArnoA,JeschkeMG.The use of dermal substitutes in burn surgery: acute phase[J].Wound Repair Regen,2014,22(1):14-22.DOI: 10.1111/wrr.12119.
[18]	De PascaleMR,SommeseL,CasamassimiA,et al.Platelet derivatives in regenerative medicine: an update[J].Transfus Med Rev,2015,29(1):52-61.DOI: 10.1016/j.tmrv.2014.11.001.
[19]	郑健生,刘胜利,彭晓菁,等.自体富血小板血浆联合Meek微型皮片修复严重烧伤患者四肢创面的效果及其机制的前瞻性研究[J].中华烧伤杂志,2021,37(8):731-737.DOI: 10.3760/cma.j.cn501120-20200427-00241.
[20]	SonkerA,DubeyA,BhatnagarA,et al.Platelet growth factors from allogeneic platelet-rich plasma for clinical improvement in split-thickness skin graft[J].Asian J Transfus Sci,2015,9(2):155-158.DOI: 10.4103/0973-6247.162712.
[21]	ZhengW,ZhaoDL,ZhaoYQ,et al.Effectiveness of platelet rich plasma in burn wound healing: a systematic review and meta-analysis[J].J Dermatolog Treat,2022,33(1):131-137.DOI: 10.1080/09546634.2020.1729949.
[22]	代站站,彭宇,房贺,等.富血小板血浆在深度烧伤创面治疗中的应用进展[J/CD].中华损伤与修复杂志(电子版),2022,17(1):65-67.DOI: 10.3877/cma.j.issn.1673-9450.2022.01.011.
[23]	YannasIV.Hesitant steps from the artificial skin to organ regeneration[J].Regen Biomater,2018,5(4):189-195.DOI: 10.1093/rb/rby012.
[24]	YannasIV,TzeranisDS,SoP.Regeneration of injured skin and peripheral nerves requires control of wound contraction, not scar formation[J].Wound Repair Regen,2017,25(2):177-191.DOI: 10.1111/wrr.12516.
[25]	YannasIV,TzeranisDS,SoP.Regeneration mechanism for skin and peripheral nerves clarified at the organ and molecular scales[J].Curr Opin Biomed Eng,2018,6:1-7.DOI: 10.1016/j.cobme.2017.12.002.
[26]	蔡玉辉,王磊,朱兴华,等.富血小板血浆结合自体网状皮移植治疗Ⅲ度烧伤创面的临床研究[J].南京医科大学学报(自然科学版),2018,38(10):1446-1450.DOI: 10.7655/NYDXBNS20181026.

Relative Articles

[1]	Zhang Ting, Liu Jiaqi, Yang Yunshu, Han Juntao, Hu Dahai, Zheng Zhao. Clinical effects of Meek skin grafting combined with platelet-rich plasma in repairing extensive deep burn wounds[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2024, 40(12): 1150-1157. doi: 10.3760/cma.j.cn501225-20231124-00206
[2]	Yang Huanna, Liang Yan, Han Dawei, Liu Lei, Xie Jiangfan, Tian Shemin, Xia Chengde, Wei Ying. Effects of artificial dermis combined with autologous skin in repairing the wounds with exposed bone and/or tendon in fingers of children after electric burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(12): 1180-1184. doi: 10.3760/cma.j.cn501225-20231101-00168
[3]	Li Yulin, Chen Nuo, Xie Weiguo. Research advances on the application of platelet concentrate products in wound repair[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2021, 37(10): 990-995. doi: 10.3760/cma.j.cn501120-20200730-00363
[4]	Di Haiping, Mu Xinling, Shi Jijing, Xue Jidong, Liu Lei, Guo Haina, Xing Peipeng, Xia Chengde. A prospective randomized controlled study of the effectiveness of artificial dermis combined with split-thickness skin for repairing wounds with bone and tendon exposure in hands and feet[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2021, 37(12): 1130-1136. doi: 10.3760/cma.j.cn501120-20210325-00103
[5]	Liu Lubing, Wen Huicai, Huang Jinjun, Xu Guizhen, Liao Huaiwei. Research advances on platelet-rich blood products combined with biological materials in wound repair[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2021, 37(4): 395-400. doi: 10.3760/cma.j.cn501120-20200531-00291
[6]	Zheng Jiansheng, Liu Shengli, Peng Xiaojing, Liu Xiaofei, Yu Le, Liang Shengqiang. A prospective study of the effect and mechanism of autologous platelet-rich plasma combined with Meek microskin grafts in repairing the wounds of limbs in severely burned patients[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2021, 37(8): 731-737. doi: 10.3760/cma.j.cn501120-20200427-00241
[8]	Li Minxiong, Ma Jun, Zheng Zijun, Niu Libin, Yang Lei. Clinical effect of bi-layered artificial dermis and autologous skin graft in repairing bone and/or tendon exposed wounds[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2020, 36(3): 179-186. doi: 10.3760/cma.j.cn501120-20191119-00437
[9]	Tian Xinli, Jiang Bo, Yan Hong. Effects of platelet-rich plasma on the survival of ultra-long dorsal random flaps in rats[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2019, 35(1): 48-53. doi: 10.3760/cma.j.issn.1009-2587.2019.01.009
[10]	Li Fang, Li Quan, Wang Lingfeng. Advances in the research of effects of mesenchymal stem cells, exosomes, and platelet-rich plasma in wound repair[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2019, 35(10): 764-768. doi: 10.3760/cma.j.issn.1009-2587.2019.10.012
[11]	Li Yang, Zheng Jiansheng, Wang Biao, Xue Wenjiao. Effects of autologous platelet-rich plasma in the repair of soft tissue defects of rabbits with free flap[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2019, 35(9): 683-689. doi: 10.3760/cma.j.issn.1009-2587.2019.09.007
[12]	Feng Guang, Hao Daifeng, Yao Dan, Zhang Xinjian, Yang Yi. Clinical effects of autologous platelet-rich plasma gel in the repair of chronic wounds[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2019, 35(6): 451-455. doi: 10.3760/cma.j.issn.1009-2587.2019.06.010
[13]	Yang Sisi, Xiao Chengzhi. Advances in the research of effects of autologous platelet-rich plasma on the treatment of burn wounds[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2018, 34(12): 910-913. doi: 10.3760/cma.j.issn.1009-2587.2018.12.017
[14]	Lei Xiaoxuan, Xu Pengcheng, Zhang Lei, Pang Mengru, Tian Ju, Cheng Biao. Effects of human adipose-derived mesenchymal stem cells and platelet-rich plasma on healing of wounds with full-thickness skin defects in mice[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2018, 34(12): 887-894. doi: 10.3760/cma.j.issn.1009-2587.2018.12.013
[16]	Chen Xin, Wang Hao, Dai Yundong, Zhang Cong, Wang Cheng. Clinical study on repair of open joint wounds and/or wounds with exposed bone fracture using negative pressure wound therapy combined with artificial dermis grafting and autologous skin grafting[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2015, 31(2): 93-97. doi: 10.3760/cma.j.issn.1009-2587.2015.02.004
[17]	CHEN Wen, ZHENG Jian-sheng. Advance in the research of platelet-rich plasma in burn treatment[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2012, 28(4): 288-290. doi: 10.3760/cma.j.issn.1009-2587.2012.04.018
[18]	ZUO Hai-bin, PENG Dai-zhi, ZHENG Bi-xiang, CHEN Bo, LIU Xiao-ling, WANG Yong, ZHOU Ling. Effect of particulate allogeneic acellular dermal matrix （PADM） combined with autologous splitthickness skin （STS） on wound healing in rats[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2011, 27(1): 10-15. doi: 10.3760/cma.j.issn.1009-2587.2011.01.005

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(4) / Tables(4)

Get Citation

PDF

XML

Article Metrics

Article views (289) PDF downloads(64)

Clinical efficacy of local injection of platelet-rich plasma combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity

doi: 10.3760/cma.j.cn501225-20230420-00134

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Clinical efficacy of local injection of platelet-rich plasma combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity

doi: 10.3760/cma.j.cn501225-20230420-00134

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Export File

Citation

Format

Content