| Objectives To investigate the clinical efficacy and value of advanced platelet rich fibrin(APRF)combined with NPWT in the treatment of chronic wounds.To provide a reasonable and effective methods for the treatment of chronic wounds.Methods Part I,We selected sixty patients,suffered from chronic wounds,who met the inclusion-criteria of the research from December 2019 to December 2020.We randomly divided them into APRF group and a FGF group(n=20).Part II,making a APRF,firstly,we need collect some blood by a disposable aseptic blood collection vessel(without anticoagulant)from the elbow vein of a patient,then we centrifuged the blood immediately at 1500r/min for 14 min,finally,the APRF was obtained.Part III,the treatment of the observation group:Debridement + APRF + NPWT(APRF group),the control group was treated with debridement NPWT.Part IV,We compared some observation indicators between the two groups,such as the wound bed score,the granulation tissue score,the wound healing rate in 10 day,the healing rate in 90 day,the complete healing time,the cost of hospitalization,and the frequency of adverse events.Results 1 granulation tissue growth score: before treatment,granulation tissue score in negative pressure group was(0.90±0.79)and aprf group(0.95±0.83),There was no significant difference between the two groups(P>0.05).After treatment,granulation tissue proliferated in varying degrees in the aprf group(4.55±0.51)was better than negative pressure group(3.25±0.79),and there was significant difference between the two groups(P<0.05);2.Wound bed score: wound bed score before treatment in negative pressure group(3.30±2.64)and aprf group(3.60±2.37),There was no significant difference between the two groups(P>0.05).When the negative pressure was removed,the wounds were all fresh granulation wounds,while in the aprf group(6.90±1.48)there was no significant difference(P>0.05)48)was significantly higher than that of negative pressure group(10.60±1.64),the difference was statistically significant(P>0.05);3.Wound healing rate after 10 days of treatment: the wound healing rate of the two groups after 10 days of treatment with the corresponding scheme was(13.03±12.54)% and(33.08±20.94)%,the difference was statistically significant(P>0.05),and the 10 day healing rate was higher in aprf group;4 90 day cure rate: after 90 days of treatment,13 patients in negative pressure group were cured and discharged,19 patients in aprf group were cured and discharged,the cure rates were 60% and 95% respectively,and the cure rate in aprf group was higher((P<0.05);5 treatment cost: the total treatment cost of the two groups were(30023.30±2966.64)yuan and(27008.63±5296.53).The medical expenses in the negative pressure group were higher than those in the aprf group((P<0.05);6 wound healing time: the average wound healing time of negative pressure group was(75.75±18.54)days and(39.60±11.41).The wound healing time of aprf group was significantly shorter than that of negative pressure group((P<0.05);Visual simulation score: there was no significant difference in visual simulation score between the two groups before treatment(P>0.05);On the day of operation,the VAS score of negative pressure group was(3.65±0.93)and aprf group(2.00±0.86),especially in the negative pressure group((P<0.05);10 days after the removal of the negative pressure device,VAS score was performed again(P<0.05),and the negative pressure group(2.65±0.93)and aprf group(1.00±0.86)The difference was statistically significant(P<0.05).Infection control: before treatment,there was no significant difference in wound infection between the two groups by chi square test(P>0.05);After 10 days of treatment,no infection was found in the aprf group,and two cases were found in the negative pressure group.The difference between the two groups was statistically significant((P<0.05).Conclusion 1 aprf combined with NPWT can accelerate wound healing and shorten wound healing time;2.Aprf combined with NPWT and drug therapy can obtain ideal anti infection effect;3.Aprf combined with NPWT in the treatment of chronic wounds can reduce medical costs to a certain extent,which has economic value;4.Aprf is safe and feasible in the treatment of complex chronic wounds.Figure3;Table11;Reference 120... |
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