富血小板纤维蛋白在小儿指/趾端缺损治疗中的效果探讨

Effect of Platelet-rich Fibrin in the Treatment of Pediatric Finger(Toe)Tip Defects

目的:探讨富血小板纤维蛋白(Platelet-rich fibrin,PRF)膜片治疗小儿指/趾端缺损的疗效。方法:选取2020年1月-2022年12月笔者医院收治的10例家属不同意皮瓣手术修复指/趾端缺损的患儿为研究对象,在清创后应用PRF膜片覆盖创面治疗,3~7 d后依据情况再次行PRF治疗,促使创面愈合。记录患儿年龄、性别、清创后创面面积,统计患儿的创面愈合时间、疼痛评分(简化McGill疼痛问卷)及家属满意度。结果:本组10例患儿,4例经PRF治疗2次愈合,4例经PRF治疗3次愈合,2例因创面相对较大较深(达骨质),经PRF治疗3次后观察创基肉芽组织自行愈合困难,给予植皮修复。8例经PRF治疗创面愈合的患儿平均治疗时间为(19.54±5.16)d,换药次数(3.18±1.63)次,疼痛评分(3.58±2.07)分,满意度评分(8.16±2.11)分,所有家属对患儿愈合创面外观及功能满意。结论:PRF膜片对小儿指/趾端缺损的临床治疗效果较好,此方法操作简单、安全,不易引起再损伤,患儿痛苦少,家属容易接受,值得临床推荐。

Objective To investigate the efficacy of Platelet-rich fibrin(PRF)in the treatment of finger/toe defect in children.Methods A total of 10 cases of children treated in the author's hospital from January 2020 to December 2022 whose families did not agree to repair finger/toe end defects with flap surgery were selected as the study objects.PRF membrane was applied to cover the wound after debridement,and PRF treatment was performed again 3-7 days later according to the situation to promote wound healing.Age,gender,wound area after debridement were recorded,and wound healing time,pain score(simplified McGill pain questionnaire)and family satisfaction were analyzed.Results Of the 10 children in this group,4 cases were healed by PRF treatment twice,4 cases were healed by PRF treatment three times,and 2 cases were healed by PRF treatment for relatively large and deep wounds(bone).After PRF treatment for three times,it was observed that the traumatic granulation tissue was difficult to heal by itself,and skin grafting was given for repair.The average treatment time of 8 children with wound healing after PRF treatment was(19.54±5.16)d,the number of dressing changes was(3.18±1.63)times,the pain score was(3.58±2.07)points,and the satisfaction score was(8.16±2.11)points.All the family members were satisfied with the appearance and function of wound healing.Conclusion PRF diaphragm has good clinical effect on finger/toe defect in children.This method is simple,safe,easy to cause reinjury,less pain in children,easy to accept by family members,and worthy of clinical recommendation.