Application Of Injectable Platelet-rich Fibrin Combined With Vacuum Sealing Drainage Technology In The Treatment Of Chronic Ulcers

Background:Injectable platelet-rich fibrin(i-PRF),as a new generation of autologous platelet concentrate,is prepared by simulating the natural coagulation process with lower centrifugal force and speed,and the content of platelets and white blood cells is higher.It is rich in fibrin and a variety of growth factors,has stronger antibacterial ability and certain antibacterial biofilm activity,simple preparation process,convenient operation and quick access,without any additives,avoiding immune rejection and allergic reactions and other problems,And has good fluidity and can be injected locally,which enhances the operability in local application,and is widely used in the field of tissue regeneration and repair and reconstruction.The treatment of chronic non-healing wounds is still a challenging problem at present.The application of vacuum sealing drainage(VSD)technology has achieved good clinical results compared with traditional treatment methods.i-PRF can promote tissue regeneration and antibacterial Active,obtain good curative effect in all aspects of oral treatment.However,i-PRF is rarely reported in the treatment of chronic refractory wounds.The purpose of the study is to explore the efficacy of i-PRF combined with closed negative pressure drainage technology compared with the pure application of closed negative pressure drainage technology in the treatment of chronic wounds.Methods:80 patients with chronic ulcers were enrolled and randomly divided into A group and B group.In the A group,ulcers was blocked through the negative pressure drainage after wound debridement,and in the B group,ulcers were conducted multi-point dispersion injection of i-PRF on the wound surface and around the wound after wound debridement,followed by closed negative pressure drainage treatment.All patients repeated the above treatment in a 7-day cycle,and wounds was repaired after reaching the restore standard.The relevant parameters of the two groups were recorded,evaluated and compared at 7 days and 14 days after treatment,including bacterial culture,leukocyte,C-reactive protein,erythrocyte sedimentation rate,fresh granulation tissue growth and NRS score,preparation time for the second-stage repair surgery and the time for complete wound healing.Results:The inflammation indexes and pain scores decreased in both groups at 7 and 14 days after treatment,while B group showed a more significant downward trend(P<0.05);B group had higher coverage of fresh granulation tissue and higher rate of bacterial conversion at 7 and 14 days after surgery,and the difference was statistically significant(P<0.05);B group had significantly lower preparation time for secondary repair surgery and complete wound healing time than VSD group(P<0.05).Conclusion:Compared with the single application of VSD technology,i-PRF combined with VSD can play a more effective role in treating chronic wounds,controlling infection,reducing pain,accelerating wound healing and reducing hospitalization time.