Clinical Application Of Negative Pressure Wound Therapy Comeined With Autologous Platelet-rich Plasma In The Treatment Of Chronic Refractory Wounds

Objectives To investigate the clinical effect of autologous Platelet-rich plasma(PRP)combined with negative pressure wound therapy(NPWT)in the treatment of Chronic refractory wounds.Methods Fifty cases of patients with Chronic refractory wounds admitted to our hospital from September 2016 to March 2018 who met the inclusion criteria were selected and divided into NPWT group(25 cases)and NPWT+PRP group(25 cases)according to the random number table method.after surgical debridement,patients in group NPWT were treated with negative pressure wound therapy,in NPWT+PRP group,PRP gel was used to cover the wound after debridement,followed by NPWT.The negative pressure values of the two groups were set at-70~-300mmHg,using the model continues,the dressing was changed once a week,and the skin graft was treated according to the healing condition of the wound.The changes of bacterial culture results of secretion before treatment and on the7th and 14th days after treatment and the levels of WBC,CRP and ESR after treatment were recorded.The bacterial negative conversion rate,VAS pain score,preparation time for second stage repair,wound healing time and hospital stay were compared between the two groups.T-test andc~2-test for the data obtained.ResultsThere was no significant difference in the levels of inflammatory factors between the two groups 7 days after treatment(P>0.05);The levels of various inflammatory indicators,bacterial negative conversion rate and infection control time of patients in NPWT+PRP group were significantly better than those in NPWT group on 7th and 14th days after treatment(P<0.05).After treatment,the VAS pain score of the two groups showed a downward trend at different time points,the difference was statistically significant(P<0.05).After 14 days of treatment,the pain score of the combined group was significantly lower than that of the simple group,the difference was statistically significant(P<0.05).The time required for the second stage repair operation,wound healing time and hospital stay in the combined group were significantly better than those in the NPWT group,with statistically significant(P<0.05).All patients were followed up for 1 to 6 months after discharge.There was no recurrence of wounds in both groups.ConclusionsNPWT combined with PRP gel has a better bacteriostatic effect than NPWT in treating chronic refractory wounds.It can effectively shorten the preparation time of wound bed and wound healing time,accelerate the re-epithelialization and improve the healing rate of wounds,relieving pain in patients,which is worthy of clinical promoting application.Figure[18];Table[7];Reference[121]...