富血小板血浆联合lando双层人工真皮治疗骨/肌腱外露的临床研究

Clinical study of platelet-rich plasma combined with lando bilayer artificial dermis in the treatment of bone/tendon exposure

目的探讨富血小板血浆(platelet-rich plasma,PRP)联合lando双层人工真皮治疗骨/肌腱外露的临床疗效。方法自2019年1月至2022年5月,柳州市工人医院创伤修复烧伤整形外科收治28例骨/肌腱外露患者,随机分为两组,对照组(单纯lando双层人工真皮)及观察组(PRP联合lando双层人工真皮),14例/组。所有患者创面经清创后,观察组采用PRP均匀涂抹创面,然后以lando双层人工真皮覆盖;对照组仅用lando双层人工真皮覆盖。比较两组术后第2、3周肉芽组织覆盖情况、创面愈合时间、瘢痕评分情况。结果28例患者创面愈合良好,所有患者骨/肌腱外露均有效覆盖,但观察组第2、3周肉芽组织覆盖率明显高于对照组(P<0.05)。肉芽组织覆盖后,3例患者采取保守治疗后创面愈合;25例采取植皮治疗,均愈合良好,创面愈合时间观察组短于对照组。所有患者获随访3个月,瘢痕评分观察组明显低于对照组(P<0.05)。结论PRP联合lando双层人工真皮可促进骨/肌腱外露创面肉芽组织生长,缩短创面愈合时间,提高创面愈合质量,可以作为骨/肌腱外露创面的治疗方法之一,值得临床推广应用。

Objective To investigate the clinical efficacy of platelet-rich plasma(PRP)combined with lando bilayer artificial dermis in the treatment of bone/tendon exposure.Methods A total of 28 patients with bone/tendon exposure admitted to our department from January 2019 to May 2022 were selected as the research subjects.According to the random number table method,they were randomly divided into two groups,the control group(single lando bilayer artificial dermis)and the observation group(platelet-rich plasma combined with lando bilayer artificial dermis),with 14 cases in each group.After wound debridement,the observation group was injected with PRP.and covered with lando bilayer artificial dermis.The control group was covered only with artificial dermis.The granulation tissue coverage.wound healing time and scar score were compared between the two groups in the 2nd and 3rd weeks afer surgery.ResultsAll patients had effective coverage of bone or tendon exposure.However,the granulation coverage in the ohservation group was significantly higher than that in the control group in the 2nd and 3rd weeks.After granulation covering,3 patients were treated with conservative treatment and 25 patients were treated with skin grafting.All patients healed well.The wound healing time of the observation group was shorter than that of the control group.The scar score of the observation group was significantly lower than that of the control group at 3 months after healing.Conclusion Platelet-rich plasma combined with lando bilayer artificial dermis can promote the growth of granulation tissue of bone/tendon exposure,shorten the healing time of wound,and improve the quality of wound healing.It can be used as one of the treatment methods for bone/tendon exposure,and is worthy of clinical promotion and application.