富血小板血浆治疗联合植皮在小面积骨外露创面中的临床应用

Clinical application of platelet-rich plasma therapy combined with autologous skin grafting to repair small area bone exposed wound

目的观察富血小板血浆(PRP)治疗联合同期自体皮片移植修复外伤后小面积骨外露创面的临床效果。方法选取60例骨外露创面患者作为研究对象,根据不同手术方式分为对照组(人工真皮联合皮片移植)和观察组(PRP联合皮片移植),每组30例。观察并比较2组患者植皮术后10 d皮片存活率、住院时间和手术费用;分别于植皮术后1、5 d采用视觉模拟评分法(VAS)评估2组患者疼痛程度,术后6个月随访时评估2组患者温哥华瘢痕量表(VSS)评分。结果观察组住院时间短于对照组,手术费用低于对照组,差异有统计学意义(P<0.05)。术后1 d时,观察组VAS评分低于对照组,差异有统计学意义(P<0.05);术后5 d时,2组VAS评分比较,差异无统计学意义(P>0.05)。2组术后10 d时皮片存活率比较,差异无统计学意义(P>0.05)。术后6个月时,观察组VSS评分低于对照组,差异有统计学意义(P<0.05)。结论PRP治疗联合同期自体皮片移植术对外伤后小面积骨外露创面有较好的临床疗效,可减轻术后疼痛和瘢痕形成,缩短患者住院时间,减少手术费用。

Objective To observe the clinical effect of platelet-rich plasma(PRP)therapy combined with simultaneous autologous skin grafting in repairing small area bone exposed wound after trauma.Methods A total of 60 cases of bone exposed wounds were selected as study objects,and were divided into control group(artificial dermis combined with skin graft)and observation group(PRP combined with skin graft)according to different surgical methods,with 30 cases in each group.The survival rate of skin graft,the length of hospital stay and operation cost were observed and compared at 10 days after skin grafting.Visual Analog Scale(VAS)score was evaluated at 1 day and 5 days after surgery to assess the pain degree.Vancouver Scar Scale(VSS)scores were evaluated at 6 months postoperative follow-up.Results Compared with the control group,the hospitalization time in the observation group shorter,and the operation cost was lower(P<0.05).VAS score at 1 day after surgery in the observation group was lower than that in the control group(P<0.05).However,there was no significant difference in VAS score 5 days after surgery and skin survival rate 10 days after surgery between the observation group and the control group(P>0.05).Six months after surgery,the VSS score of the observation group was lower than that of the control group(P<0.05).Conclusion PRP therapy combined with simultaneous autologous skin grafting is effective in repairing small area bone exposure wounds,and can relieve postoperative pain and scar formation,shorten hospital stay and reduce surgical costs.