Application study of autologous platelet-rich plasma gel combined with vacuum sealing drainage in treatment of infectious wounds_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

TIAN Huakai ¹ , ZHOU Taicheng ² , MA Ning ² , YU Zhuomin ² , TANG Fuxin ² ,  ZONG Zhen ¹

1. Department of General Surgery, The Second Affiliated Hospital, Nanchang University, Nanchang 330006, P. R. China;
2. Department of Gastrointestinal, Hernia and Abdominal Wall Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, P. R. China;

Corresponding author：

ZONG Zhen, Email: ndefy16133@ncu.edu.cn

Keywords：

surgical wound infection; chronic poor healing; platelet-rich plasma gel; vacuum sealing drainage

DOI：

10.7507/1007-9424.202010117

Video：

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Objective To investigate the effect of vacuum sealing drainage (VSD) combined with autologous platelet-rich plasma gel (PRP) on postoperative wound infection and chronic poor wound healing, so as to provide more economical and safe treatment in clinic.Methods The patients with postoperative wound infection and chronic poor wound healing in the Second Affiliated Hospital of Nanchang University and Sixth Affiliated Hospital of Sun Yat-sen University from September 2018 to July 2019 were collected, then were divide into PRP+VSD group and VSD group according to treatment methods. The patients in the PRP+VSD group were filled with PRP and activator calcium thrombin following debridement, then covered with silver ion dressing and continuous VSD; in the VSD group were directly covered with silver ion dressing and then continuous VSD. The general situations of patients in the two groups during the process of replacing the VSD and the wound condition during dressing replacing were observed.Results There were 100 patients in this study, 50 in the PRP+VSD group and 50 in the VSD group. There were no significant differences in the age, gender, body mass index, wound area before treatment, and wound infection type between the two groups (P>0.05). Compared with the VSD group, the PRP+VSD group had higher score of fresh granulation tissue coverage area (P<0.05), shorter wound closure time (P<0.05), shorter wound healing time (P<0.05), lower pain score (P<0.05), and less hospitalization expenses (P<0.05), lower rates of second debridement (P<0.05) and recurrent infection (P<0.05).Conclusion Autologous PRP combined with VSD in treatment of postoperative wound infection and chronic poor wound healing could shorten growth time of wound granulation tissue, promote rapid wound healing, reduce cost, and provide an economic, safe, and effective treatment method for clinical practice.

Citation： TIAN Huakai, ZHOU Taicheng, MA Ning, YU Zhuomin, TANG Fuxin, ZONG Zhen. Application study of autologous platelet-rich plasma gel combined with vacuum sealing drainage in treatment of infectious wounds. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(7): 873-877. doi: 10.7507/1007-9424.202010117 Copy

1.	Yoshioka T, Kondo Y, Fujiwara T. Successful wound treatment using negative pressure wound therapy without primary closure in a patient undergoing highly contaminated abdominal surgery. Surg Case Rep, 2018, 4(1): 85.
2.	陶一明, 王志明. 《外科手术部位感染的预防指南(2017)》更新解读. 中国普通外科杂志, 2017, 26(7): 821-824.
3.	Dohmen PM, Markou T, Ingemansson R, et al. Use of incisional negative pressure wound therapy on closed median sternal incisions after cardiothoracic surgery: clinical evidence and consensus recommendations. Med Sci Monit, 2014, 20: 1814-1825.
4.	李明霞, 杨梅, 李霞, 等. 负压封闭引流技术在胸外科手术后胸壁切口感染治疗中的临床应用. 中国胸心血管外科临床杂志, 2014, 21(3): 421-424.
5.	Cole BJ, Seroyer ST, Filardo G, et al. Platelet-rich plasma: where are we now and where are we going? Sports Health, 2010, 2(3): 203-210.
6.	马丽. 自体富血小板凝胶在治疗糖尿病足和糖尿病皮肤慢性溃疡中的临床疗效观察. 中国现代药物应用, 2014, 8(8): 86-88.
7.	Qiu ML, Chen DY, Shen CY, et al. Platelet-rich plasma-loaded poly (d,l-lactide)-poly (ethylene glycol)-poly(d,l-lactide) hydrogel dressing promotes full-thickness skin wound healing in a rodent model. Int J Mol Sci, 2016, 17(7): 1001.
8.	李芳. 剖宫产术后切口感染的高危因素分析及对策. 世界最新医学信息文摘, 2015, 15(11): 75-79.
9.	Chida K, Watanabe J, Suwa Y, et al. Risk factors for incisional surgical site infection after elective laparoscopic colorectal surgery. Ann Gastroenterol Surg, 2019, 3(2): 202-208.
10.	高峰, 王捷熙, 韩颖. 富血小板血浆应用于创伤修复的研究进展. 中国实验血液学杂志, 2009, 17(3): 840-843.
11.	Martínez-Zapata MJ, Martí-Carvajal A, Solà I, et al. Efficacy and safety of the use of autologous plasma rich in platelets for tissue regeneration: a systematic review. Transfusion, 2009, 49(1): 44-56.
12.	Anitua E, Prado R, Muruzabal F. Why dilute the regenerative power of platelet-rich plasma? J Craniomaxillofac Surg, 2019, 47(3): 530-531.
13.	Anitua E, Prado R, Orive G. Allogeneic platelet-rich plasma: at the dawn of an off-the-shelf therapy? Trends Biotechnol, 2017, 35(2): 91-93.
14.	李卓男, 张连波. 富血小板血浆的临床应用. 中国美容整形外科杂志, 2019, 30(3): 184-187.
15.	伍亮, 熊小龙, 相大勇, 等. TGF-β1 和 VEGF 在富血小板血浆治疗跟腱断裂模型中的表达及意义. 中华临床医师杂志(电子版), 2013, 7(4): 1639-1645.
16.	Baria M, Vasileff WK, Miller M, et al. Cellular components and growth factor content of platelet-rich plasma with a customizable commercial system. Am J Sports Med, 2019, 47(5): 1216-1222.
17.	Ulusoy AT, Turedi I, Cimen M, et al. Evaluation of blood clot, platelet-rich plasma, platelet-rich fibrin, and platelet pellet as scaffolds in regenerative endodontic treatment: a prospective randomized trial. J Endod, 2019, 45(5): 560-566.
18.	Chen L, Wang C, Liu H, et al. Antibacterial effect of autologous platelet-rich gel derived from subjects with diabetic dermal ulcers in vitro. J Diabetes Res, 2013, 2013: 269527.
19.	Li H, Hamza T, Tidwell JE, et al. Unique antimicrobial effects of platelet-rich plasma and its efficacy as a prophylaxis to prevent implant-associated spinal infection. Adv Healthc Mater, 2013, 2(9): 1277-1284.
20.	López C, Carmona JU, Giraldo CE, et al. Bacteriostatic effect of equine pure platelet-rich plasma and other blood products against methicillin-sensitive Staphylococcus aureus. An in vitro study. Vet Comp Orthop Traumatol, 2014, 27(5): 372-378.
21.	曾志强, 陈汝福, 裘华德, 等. 负压封闭引流技术治疗重症急性胰腺炎的临床研究. 中国现代医学杂志, 2010, 20(6): 844-847.
22.	裘华德, 王彦峰. 负压封闭引流技术介绍. 中国实用外科杂志, 1998, 18(4): 233-234.
23.	吴畏, 邱冬梅, 赵洁玉. 负压封闭引流在乳腺癌改良根治术后腋窝引流中的应用价值. 中国普外基础与临床杂志, 2019, 26(2): 221-223.
24.	任龙, 谢贻祥, 王传思, 等. VSD 技术治疗高位肛周脓肿的临床疗效. 中国普外基础与临床杂志, 2017, 24(3): 282-285.
25.	Virani SR, Dahapute AA, Bava SS, et al. Impact of negative pressure wound therapy on open diaphyseal tibial fractures: A prospective randomized trial. J Clin Orthop Trauma, 2016, 7(4): 256-259.

1. Yoshioka T, Kondo Y, Fujiwara T. Successful wound treatment using negative pressure wound therapy without primary closure in a patient undergoing highly contaminated abdominal surgery. Surg Case Rep, 2018, 4(1): 85.
2. 陶一明, 王志明. 《外科手术部位感染的预防指南(2017)》更新解读. 中国普通外科杂志, 2017, 26(7): 821-824.
3. Dohmen PM, Markou T, Ingemansson R, et al. Use of incisional negative pressure wound therapy on closed median sternal incisions after cardiothoracic surgery: clinical evidence and consensus recommendations. Med Sci Monit, 2014, 20: 1814-1825.
4. 李明霞, 杨梅, 李霞, 等. 负压封闭引流技术在胸外科手术后胸壁切口感染治疗中的临床应用. 中国胸心血管外科临床杂志, 2014, 21(3): 421-424.
5. Cole BJ, Seroyer ST, Filardo G, et al. Platelet-rich plasma: where are we now and where are we going? Sports Health, 2010, 2(3): 203-210.
6. 马丽. 自体富血小板凝胶在治疗糖尿病足和糖尿病皮肤慢性溃疡中的临床疗效观察. 中国现代药物应用, 2014, 8(8): 86-88.
7. Qiu ML, Chen DY, Shen CY, et al. Platelet-rich plasma-loaded poly (d,l-lactide)-poly (ethylene glycol)-poly(d,l-lactide) hydrogel dressing promotes full-thickness skin wound healing in a rodent model. Int J Mol Sci, 2016, 17(7): 1001.
8. 李芳. 剖宫产术后切口感染的高危因素分析及对策. 世界最新医学信息文摘, 2015, 15(11): 75-79.
9. Chida K, Watanabe J, Suwa Y, et al. Risk factors for incisional surgical site infection after elective laparoscopic colorectal surgery. Ann Gastroenterol Surg, 2019, 3(2): 202-208.
10. 高峰, 王捷熙, 韩颖. 富血小板血浆应用于创伤修复的研究进展. 中国实验血液学杂志, 2009, 17(3): 840-843.
11. Martínez-Zapata MJ, Martí-Carvajal A, Solà I, et al. Efficacy and safety of the use of autologous plasma rich in platelets for tissue regeneration: a systematic review. Transfusion, 2009, 49(1): 44-56.
12. Anitua E, Prado R, Muruzabal F. Why dilute the regenerative power of platelet-rich plasma? J Craniomaxillofac Surg, 2019, 47(3): 530-531.
13. Anitua E, Prado R, Orive G. Allogeneic platelet-rich plasma: at the dawn of an off-the-shelf therapy? Trends Biotechnol, 2017, 35(2): 91-93.
14. 李卓男, 张连波. 富血小板血浆的临床应用. 中国美容整形外科杂志, 2019, 30(3): 184-187.
15. 伍亮, 熊小龙, 相大勇, 等. TGF-β1 和 VEGF 在富血小板血浆治疗跟腱断裂模型中的表达及意义. 中华临床医师杂志(电子版), 2013, 7(4): 1639-1645.
16. Baria M, Vasileff WK, Miller M, et al. Cellular components and growth factor content of platelet-rich plasma with a customizable commercial system. Am J Sports Med, 2019, 47(5): 1216-1222.
17. Ulusoy AT, Turedi I, Cimen M, et al. Evaluation of blood clot, platelet-rich plasma, platelet-rich fibrin, and platelet pellet as scaffolds in regenerative endodontic treatment: a prospective randomized trial. J Endod, 2019, 45(5): 560-566.
18. Chen L, Wang C, Liu H, et al. Antibacterial effect of autologous platelet-rich gel derived from subjects with diabetic dermal ulcers in vitro. J Diabetes Res, 2013, 2013: 269527.
19. Li H, Hamza T, Tidwell JE, et al. Unique antimicrobial effects of platelet-rich plasma and its efficacy as a prophylaxis to prevent implant-associated spinal infection. Adv Healthc Mater, 2013, 2(9): 1277-1284.
20. López C, Carmona JU, Giraldo CE, et al. Bacteriostatic effect of equine pure platelet-rich plasma and other blood products against methicillin-sensitive Staphylococcus aureus. An in vitro study. Vet Comp Orthop Traumatol, 2014, 27(5): 372-378.
21. 曾志强, 陈汝福, 裘华德, 等. 负压封闭引流技术治疗重症急性胰腺炎的临床研究. 中国现代医学杂志, 2010, 20(6): 844-847.
22. 裘华德, 王彦峰. 负压封闭引流技术介绍. 中国实用外科杂志, 1998, 18(4): 233-234.
23. 吴畏, 邱冬梅, 赵洁玉. 负压封闭引流在乳腺癌改良根治术后腋窝引流中的应用价值. 中国普外基础与临床杂志, 2019, 26(2): 221-223.
24. 任龙, 谢贻祥, 王传思, 等. VSD 技术治疗高位肛周脓肿的临床疗效. 中国普外基础与临床杂志, 2017, 24(3): 282-285.
25. Virani SR, Dahapute AA, Bava SS, et al. Impact of negative pressure wound therapy on open diaphyseal tibial fractures: A prospective randomized trial. J Clin Orthop Trauma, 2016, 7(4): 256-259.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application study of autologous platelet-rich plasma gel combined with vacuum sealing drainage in treatment of infectious wounds

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