关键词: 自体富血小板血浆凝胶, 网状植皮, 皮肤缺损, 创面愈合

Abstract: Objective To investigate the clinical effect of autologous platelet-rich plasma(PRP) gel technique in the treatment of large area skin defect wounds with reticular skin grafting. Methods From January 2018 to December 2019,39 patients who met the inclusion criteria and needed skin grafting on large wound surface were included in the control group,a total of 41 patients who met the inclusion criteria and required skin grafting from January 2020 to December 2021 were into the Study Group.The patients in both groups were made into a large mesh skin graft by taking the medial thigh skin with an electric skin knife,while the patients in the observation group were smeared on the inner surface of the mesh skin with autologous platelet-rich plasma gel,and the patients in the control group were wetted with normal saline,the pressure bandage was removed at 7 days after operation,and the dressing was changed at 10 days and 13 days after operation.The healing rate of skin graft was calculated on the 7th,10th and 13th day after operation,and the pain degree was evaluated by visual analogue scale(VAS) at the 1st and 2nd week after operation Vancouver scar scale(VSS) was used to evaluate the degree of scar hyperplasia at the 1st and 2nd month,and the adverse reactions were observed during the treatment. Results On the 7th,10th and 13th day after operation,the healing rates of the skin graft in the observation group were(51.1±9.8)%,(79.3±7.8)% and(95.5±3.5)% respectively,while those in the control group were(45.5±9.1)%,(67.8±8.1)% and(86.3±5.7)% respectively,the healing rate of skin graft in the observation group was significantly higher than that in the control group(P＜0.05),and the pain VAS scores were(3.1±1.2) and(1.1±0.3) at the 1st and 2nd week after operation in the Observation Group,respectively,the VAS scores of the control group were(4.0±1.4) and(1.7±0.5)，respectively.The pain scores of the observation group were significantly lower than those of the control group(P＜0.05),The VSS scores of hypertrophic scar in the observation group were(7.1±1.9) and(3.3±1.1) at the 1st and 2nd month after wound healing respectively,and those of the control group were(9.3±2.1) and(4.7±1.5) respectively,the scores of scar hyperplasia in the Observation Group were significantly lower than those in the control group(P＜0.05),the adverse reaction rate in the observation group was 7.3%,the adverse reaction rate in the control group was 23%,the incidence of adverse reactions in the observation group was significantly lower than that in the control group(P＜0.05).Conclusion Autologous platelet-rich plasma gel can promote the skin growth of mesh skin grafting wound,shorten the healing time,reduce the degree of pain,reduce scar hyperplasia,and reduce the incidence of adverse reactions.

Key words: platelet-rich plasma gel, mesh skin graft, skin defect, wound healing