Abstract：Objective: To investigate the effect of platelet-rich fibrin (PRF) on inflammatory response in refractory wounds. Methods: From September 2020 to December 2022, 40 patients with refractory wounds diagnosed in the Department of Burns and Plastic Surgery of the Affiliated Hospital of Chengde Medical University were randomly divided into the PRF group and the control group, with 20 cases in each group. After admission, all patients underwent wound debridement and iodine disinfection. The PRF group was treated with PRF on the wound surface, and the dressing was changed every other day. The control group was treated with sterile dressing change. Wound tissue was collected before treatment, on the 7th and 14th day after treatment for HE staining to observe the pathological changes of the wound. Venous blood was drawn to detect the changes of white blood cell (WBC), C-reactive protein (CRP), and procalcitonin (PCT) levels. Immunohistochemical staining of CD34 was performed on the wound tissue to observe the vascularization of the wound before and after treatment. Flow cytometry was used to compare the changes of CD4+T cells and CD8+T cells in the blood of patients before and on the 7th day after treatment, as well as the CD4+T/CD8+T ratio. Results: There was no statistically significant difference in gender, age and course of disease before admission between the two groups (P>0.05). HE staining showed that before treatment, there was a large number of inflammatory cell infiltration and a small number of vessels in the wounds of both groups. On the 7th day after treatment, the inflammatory cell infiltration in the PRF group was reduced, and new vessels were formed. On the 14th day after treatment, the inflammatory cells in the PRF group were significantly reduced, the epithelium proliferated, and new skin appendages appeared. There was no statistically significant difference in WBC, CRP, and PCT levels before treatment (P>0.05). On the 7th and 14th day after treatment, the inflammatory indicators all decreased, and the differences between the two groups were statistically significant (P<0.05). On the 7th and 14th day after treatment, the number of CD34 positive cells in the PRF group was more than that in the control group, and the number of new vessels was more. The epithelialization of the wound also appeared earlier than that in the control group. There was no statistically significant difference in CD4+T cells, CD8+T cells, and CD4+/CD8+ ratio between the two groups before treatment (P>0.05). On the 7th day after treatment, the CD4+T and CD4+/CD8+ ratio cells in both groups increased, and the CD8+T cells decreased. There were statistically significant differences in CD4+T cells, CD8+T cells, and CD4+/CD8+ ratio between the two groups (P<0.05). Conclusion: PRF can reduce inflammatory response, improve blood circulation and immune function in refractory wounds.
[1] 孟浩,苏建隆,王睿,等.899例体表慢性难愈合创面住院患者临床流行病学研究[J].解放军医学院学报,2022,43(3):254-257. [2] 秦新愿,王江宁.自体富血小板血浆局部注射治疗糖尿病足溃疡的临床研究[J].中国修复重建外科杂志,2019,33(12):1548-1550. [3] Qian ZY,Wang HP,Bai YT,et al.Improving chronic diabetic wound healing through an injectable and self-healing hydrogel with platelet-rich plasma release[J].ACS Appl Mater Interfaces,2020,12(50):55659-55674. [4] 刘磊,狄海萍,郭海娜,等.低温冷冻干燥后富血小板纤维蛋白生物学性状的变化[J].中国组织工程研究,2021,25(31):4995-4999. [5] 朱伟东,程飚.慢性创面微生物群组成和愈合与患者遗传学有关[J].中华烧伤杂志,2020,36(11):1069. [6] Baca-Gonzalez LR,Serrano Zamora L,Rancan,et al.Plasma rich in growth factors (PRGF) and leukocyte-platelet rich fibrin (L-PRF):comparative release of growth factors and biological effect on osteoblasts[J].Int Implant Dent,2022,8(1):39. [7] Aydinyurt HS,Sancak T,Taskin C,et al.Effects of injectable platelet-rich fibrin in experimental periodontitis in rats[J].Odontology,2021,109(2):422-432. [8] Oneto P,Etulain J.PRP in wound healing applications[J].Platelets,2021,32(2):189-199. [9] Scopelliti F,Cattani C,Dimartino V,et al.Platelet derivatives and the immunomodulation of wound healing[J].Int Mol Sci,2022,23(15):8370. [10] Shashank B,Bhushan M.Injectable Platelet-Rich Fibrin (PRF):The newest biomaterial and its use in various dermatological conditions in our practice:a case series[J].Cosmet Dermatol,2021,20(5):1421-1426. [11] 田悦,陈慧珊,张佩佩,等.血管内皮生长因子在牙周组织再生中作用的研究进展[J].吉林大学学报(医学版),2022,48(2):547-549.
2024, Vol. 30 
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