自体富血小板纤维蛋白提取液复合德莫林对皮肤创伤修复的影响

Effects of Autologous Platelet-rich Fibrin Extract Combined with Dermlin on Skin Wound Repair

目的观察自体富血小板纤维蛋白(PRF)提取液复合德莫林对患者手术后切口愈合及瘢痕形成的影响。方法选取2015年1月~2017年12月于南宁市第一人民医院就诊的腹部、颈部、乳腺开放性手术患者各40例,按照配伍分组将三种手术患者分为A、B、C、D四组,每组腹部、颈部、乳腺开放性手术患者各10例,A组采用自体PRF提取液复合德莫林涂抹切口、B组采用PRF提取液涂抹切口、C组采用德莫林喷剂涂抹切口、D组采用生理盐水清洗切口。从患者外周静脉血提取出PRF,分别在第1、3、7、14、28天收集PRF分泌的上清液进行细胞因子检测;比较各组不同部位术后切口愈合时间、切口疼痛级别、瘢痕面积。结果PRF凝胶分泌上清液中所包含的各种细胞因子第1~7天浓度逐渐升高,第7天达峰值,随后浓度逐渐降低;A组颈部、乳腺、腹部切口愈合时间、切口疼痛级别均短于B、C、D组,各组与对照组比较,差异有统计学意义(P<0.05);A组颈部、乳腺、腹部术后切口瘢痕增生程度低于B、C、D组,差异有统计学意义(P<0.05);B组颈部、乳腺及腹部术后切口瘢痕增生程度低于C、D组,差异有统计学意义(P<0.05);C组颈部、乳腺及腹部术后切口瘢痕增生程度低于D组,差异有统计学意义(P<0.05)。结论PRF凝胶提取液中包含多种细胞因子,提取液复合德莫林对减少患者术后切口愈合时间、切口疼痛级别、瘢痕面积起到协同作用。

Objective To observe the effect of autologous platelet-rich fibrin(PRF)extract combined with Dermlin on wound healing and scar formation after surgery.Methods 40 patients with open surgery on the abdomen,neck and breast treated in Nanning First People’s Hospital from January 2015 to December 2017 were selected,and the three surgical patients were divided into A,B,C and D according to the compatibility group 4 groups,10 patients in each group for open surgery on the abdomen,neck and breast,group A was treated with autologous PRF extract combined with Dermlin for incision,group B was treated with PRF extract for incision and group C was treated with Dermlin spray smear the incision.Group D was cleaned with normal saline.PRF was extracted from the patients’peripheral venous blood,and the supernatant secreted by PRF was collected on days 1,3,7,14,and 28 for cytokine detection;the incision healing time,incision pain level,and scar of different parts of each group were compared area.Results The concentration of various cytokines contained in the supernatant secreted by the PRF gel gradually increased from day 1 to day 7,peaked on day 7,and then gradually decreased;group A neck,breast,abdominal incision healing time,incision pain the grades were shorter than those in groups B,C,and D,the difference between each group and the control group was statistically significant(P<0.05);the degree of scar hyperplasia in the neck,breast,and abdomen after surgery in group A was lower than that in groups B,C,and D,the difference was statistically significant in group(P<0.05);the scar hyperplasia of neck,breast and abdomen in group B was lower than that in groups C and D after operation,the difference was statistically significant(P<0.05);The postoperative incision scar hyperplasia in group C was lower than that in group D,the difference was statistically significant(P<0.05).Conclusion The PRF gel extract contains multiple cytokines,and the extract combined with Dermlin can play a synergistic role in reducing postoperative incision healing time,incision pain level,and scar area.