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. 《外科手術部位感染的預防指南(2017)》更新解讀. 中國普通外科雜志, 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, 楊梅, 李霞, 等. 負壓封閉引流技術在胸外科手術后胸壁切口感染治療中的臨床應用. 中國胸心血管外科臨床雜志, 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.	馬麗. 自體富血小板凝膠在治療糖尿病足和糖尿病皮膚慢性潰瘍中的臨床療效觀察. 中國現代藥物應用, 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. 剖宮產術后切口感染的高危因素分析及對策. 世界最新醫學信息文摘, 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, 韓穎. 富血小板血漿應用于創傷修復的研究進展. 中國實驗血液學雜志, 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, 張連波. 富血小板血漿的臨床應用. 中國美容整形外科雜志, 2019, 30(3): 184-187.
15.	伍亮, 熊小龍, 相大勇, 等. TGF-β1 和 VEGF 在富血小板血漿治療跟腱斷裂模型中的表達及意義. 中華臨床醫師雜志(電子版), 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.	曾志強, 陳汝福, 裘華德, 等. 負壓封閉引流技術治療重癥急性胰腺炎的臨床研究. 中國現代醫學雜志, 2010, 20(6): 844-847.
22.	裘華德, 王彥峰. 負壓封閉引流技術介紹. 中國實用外科雜志, 1998, 18(4): 233-234.
23.	吳畏, 邱冬梅, 趙潔玉. 負壓封閉引流在乳腺癌改良根治術后腋窩引流中的應用價值. 中國普外基礎與臨床雜志, 2019, 26(2): 221-223.
24.	任龍, 謝貽祥, 王傳思, 等. VSD 技術治療高位肛周膿腫的臨床療效. 中國普外基礎與臨床雜志, 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. 《外科手術部位感染的預防指南(2017)》更新解讀. 中國普通外科雜志, 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, 楊梅, 李霞, 等. 負壓封閉引流技術在胸外科手術后胸壁切口感染治療中的臨床應用. 中國胸心血管外科臨床雜志, 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. 馬麗. 自體富血小板凝膠在治療糖尿病足和糖尿病皮膚慢性潰瘍中的臨床療效觀察. 中國現代藥物應用, 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. 剖宮產術后切口感染的高危因素分析及對策. 世界最新醫學信息文摘, 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, 韓穎. 富血小板血漿應用于創傷修復的研究進展. 中國實驗血液學雜志, 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, 張連波. 富血小板血漿的臨床應用. 中國美容整形外科雜志, 2019, 30(3): 184-187.
15. 伍亮, 熊小龍, 相大勇, 等. TGF-β1 和 VEGF 在富血小板血漿治療跟腱斷裂模型中的表達及意義. 中華臨床醫師雜志(電子版), 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. 曾志強, 陳汝福, 裘華德, 等. 負壓封閉引流技術治療重癥急性胰腺炎的臨床研究. 中國現代醫學雜志, 2010, 20(6): 844-847.
22. 裘華德, 王彥峰. 負壓封閉引流技術介紹. 中國實用外科雜志, 1998, 18(4): 233-234.
23. 吳畏, 邱冬梅, 趙潔玉. 負壓封閉引流在乳腺癌改良根治術后腋窩引流中的應用價值. 中國普外基礎與臨床雜志, 2019, 26(2): 221-223.
24. 任龍, 謝貽祥, 王傳思, 等. VSD 技術治療高位肛周膿腫的臨床療效. 中國普外基礎與臨床雜志, 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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