自体血小板凝胶治疗糖尿病皮肤溃疡患者综合护理效果分析

目的 观察自体血小板凝胶治疗糖尿病皮肤溃疡患者综合护理效果.方法 选取2017年8月—2018年8月该院收诊的23例糖尿病皮肤溃疡患者作为研究对象,基于常规治疗,实施自体血小板凝胶治疗并进行综合护理.结果 治疗12周后,23例患者,17例皮肤溃疡愈合,愈合率73.91％,治疗总有效率为86.96％;治疗后,患者溃疡愈合...     

富血小板凝胶在糖尿病足溃疡治疗中的应用

富血小板凝胶是近年来新出现的辅助治疗糖尿病足溃疡(DFU)的方法之一.局部应用富血小板凝胶治疗DFU可有效改善DFU的难愈合性并提高溃疡愈合率,且无明显不良反应发生;也可降低截肢率,且没有增加医疗总费用.富血小板凝胶治疗DFU的作用机制可能与其中富含的生长因子、细胞因子和白细胞等有关,还可能与凝胶超微结构、溃疡中基质金属蛋白酶的变化有关.     

负压创伤治疗联合自体富血小板凝胶治疗糖尿病性溃疡的疗效观察

目的观察智能负压创伤治疗技术(negative-pressurewound therapy,NPWT)联合自体富血小板凝胶(autologous platelet-rich gel,APG)治疗糖尿病性溃疡,包括糖尿病足和糖尿病皮肤慢性溃疡的疗效,为临床治疗提供依据。方法选取2017年3月-2019年3月该院内分泌科门诊及住院治疗的60例糖尿病足和糖尿病皮肤慢性溃疡的患者为研究对象。将患者依据随机数表法分为观察组(30例)和对照组(30例)。观察组患者给予NPWT联合APG治疗。对照组患者给予NPWT治疗后予常规换药治疗。两组均辅以控制血糖、血压、抗凝、抗感染及对症支持治疗。比较两组患者的疗效和溃疡愈合时间。结果观察组患者总有效率为96.7%,对照组患者总有效率为70.0%,观察组总有效率显著高于对照组,差异有统计学意义(P<0.05)。观察组患者平均愈合时间为(49.4±15.2)d,对照组为(91.2±26.8)d,观察组溃疡愈合时间显著短于对照组,差异有统计学意义(P<0.05)。结论 NPWT联合APG治疗糖尿病足及糖尿病皮肤慢性溃疡,疗效显著,明显缩短溃疡愈合时间。     

自体富血小板血浆治疗糖尿病足溃疡临床效果分析

目的 对糖尿病足溃疡患者采取自体富血小板血浆治疗,观察实际疗效.方法 对2018年6月—2019年6月间在该院进行治疗的60例糖尿病足溃疡患者进行回顾性分析,根据治疗方案的不同分为治疗组(n=30)及对照组(n=30).对照组以常规方法治疗,治疗组以自体富血小板血浆治疗,对比两组患者总有效率、愈合时间以及不良反应率.结...     

自体血小板凝胶在糖尿病足溃疡治疗中的应用研究

目的 观察自体富血小板凝胶治疗糖尿病足溃疡（DFU）的疗效. 方法 72例DFU患者按照数字随机法分为两组.治疗组采用自体富血小板凝胶外敷;对照组采用常规疗法.比较两组DFU治愈率、好转率及愈合时间. 结果 两组间年龄、糖尿病病程、FPG、FIns、HbA1c、稳态模型评估胰岛素抵抗指数（HOMA-IR）、BMI、TG、TC、LDL-C、HDL-C、溃疡面积及溃疡体积比较差异均无统计学意义（P＞0.05）.两组Wagner Ⅰ级DFU治疗的疗效比较差异均无统计学意义（P＞0.05）.在WagnerⅡ、Ⅲ级DFU病例中,治疗组治愈率（66.7％、70.0％）、总有效率（94.4％、90.0％）均高于对照组（治愈率：26.3％、57.9％;总有效率：10.0％、30.0％）（P＜0.05）;治疗组Wagner Ⅰ～Ⅲ级DFU愈合时间均短于对照组[WagnerⅠ级：（14.75±1.82） vs （22.00±1.63）d;WagnerⅡ级：（27.12±2.15） vs （34.93±1.44）d;WagnerⅢ级：（41.89±3.22） vs （53.83±1.17）d] （P＜0.05）. 结论 自体富血小板凝胶可能具有促进DFU愈合的作用.     

自体富血小板凝胶治疗难愈性糖尿病足溃疡的临床疗效分析

目的 探讨难愈性糖尿病足溃疡患者应用自体富血小板凝胶治疗的临床价值。方法 选取2021年7月—2022年9月琼海市人民医院接收的62例难愈性糖尿病足溃疡患者作为研究对象,随机分为研究组与对照组,每组31例。对照组为常规的碘伏治疗,研究组为自体富血小板凝胶治疗,比较两组临床疗效、溃疡愈合速率及愈合时间,并对两组不良反应进行分析对比。结果 研究组总有效率高于对照组,差异有统计学意义（P<0.05）。研究组溃疡愈合速率较对照组高,且愈合时间较对照组短,差异有统计学意义（P<0.05）。两组不良反应总发生率对比,差异无统计学意义（P>0.05）。结论 在难愈性糖尿病足溃疡患者的治疗中,采用自体富血小板凝胶治疗,效果较好,可加速患者创面预后,提高治愈率,且治疗时间明显缩短,安全性较高,在减轻患者痛苦的同时,可降低经济负担。     

下肢经皮动脉腔内支架成形术联合自体富血小板凝胶治疗糖尿病足:3例报告

一、资料与方法 1.一般资料 患者1,女性,73岁.因发现血糖升高8年余,右足破溃、疼痛1月余,于2009年6月1日入院.院外予抗生素及局部用药(不详)治疗20余天无改善.入院时查体:体温37.4℃ ,血压110/64mmHg,双下肢浅感觉减退,皮温降低,双足背动脉搏动消失,右足第3、4趾及邻近足底变黑.按Wagner分级法[2]诊断为Ⅴ级.HbA1c 9%,TG 1.8mmol/L,TC 5.2 mmol/L,LDL-C 2.7 mmol/L.     

经皮动脉腔内支架成形术联合自体富血小板凝胶涂布治疗糖尿病足（附5例报告）

目的观察下肢经皮动脉腔内支架成形术联合自体富血小板凝胶涂布治疗糖尿病足的临床疗效。方法对5例糖尿病足患者,围手术期予以抗血小板聚集口服及常规治疗。行双下肢DSA,明确狭窄或闭塞血管,行经皮动脉腔内支架成形术,用自体富血小板凝胶外敷创面。术后常规抗凝治疗。结果5例手术均成功。术后患肢供血改善,伤口愈合。术后3—6个月,均未出现血管狭窄。结论下肢经皮动脉腔内支架成形术联合自体富血小板凝胶是治疗糖尿病足安全、有效的方法。     

横向骨搬运联合自体富血小板治疗糖尿病足的临床疗效

目的:分析横向骨搬运联合自体富血小板(PRP)治疗糖尿病足的效果.方法:择选2019.1-2021.1月我院收治的100例糖尿病足患者,随机分为对照组和实验组,每组50例,对照组使用常规治疗,实验组使用横向骨搬运联合PRP治疗,对比两组的临床疗效.结果:实验组治疗总有效率96％明显高于对照组的78％(P<0.05).实...     

自体富血小板血浆治疗糖尿病足的临床效果观察

目的 探讨自体富血小板血浆治疗糖尿病足的临床效果。方法 选择2020年7月—2021年9月该院收治的糖尿病足患者80例为研究对象。按照随机数表法分为两组,各40例。对照组实施清创换药,观察组于对照组基础上联合自体富血小板血浆治疗,比较两组治疗2周后肉芽组织覆盖率与生长厚度,创面疼痛缓解时间、结痂时间和愈合时间,比较两组治疗前后促创面生长因子,统计两组治疗期间发生不良反应的总比例。结果 观察组治疗2周后肉芽组织覆盖率高于对照组,差异有统计学意义(P<0.05),肉芽组织生长厚度大于对照组,差异有统计学意义(P<0.05);观察组创面疼痛缓解时间、结痂时间和愈合时间均显著短于对照组,差异有统计学意义(P<0.05);干预后观察组晚期糖基化终末产物（AGEs）水平低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05),观察组血管内皮生长因子（VEGF）水平高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组发生创面疼痛、创面感染、创面颜色苍白和局部皮疹的总发生率显著低于对照组,差异有统计学意义(P<0.05)。结论 自体富血小...     

Autologous platelet-rich gel in the treatment of diabetic foot ulcers: A retrospective study

This study retrospectively investigated the effectiveness and safety of autologous platelet-rich gel (APRG) for the treatment of diabetic foot ulcers (DFU). In this retrospective study, we reviewed the electronic medical records (EMR) of 72 patients with DFU. The patients were allocated to a treatment group (n = 36) or a control group (n = 36). The patients in both groups received standard care (SC) and dressing change. In addition, patients in the treatment group also received APRG. Patients in both groups were treated for 12 weeks. The outcomes were DFU healing time (days), length of hospital stay (days), healing rate of DFU, DFU surface area reduction (cm²), and adverse events. We assessed and analyzed the outcomes before and after the 12-week treatment period. After treatment, there were significant differences in DFU healing time (P = .04), length of hospital stay (P = .04), DFU healing rate, and DFU surface area reduction (P < .01). Regarding safety, no EMR reported adverse events in this study. The results of this study showed that the APRG may benefit patients with DFU. However, high-quality prospective randomized controlled trials are required to verify these findings.     

A prospective, randomized, controlled trial of autologous platelet-rich plasma gel for the treatment of diabetic foot ulcers

Nonhealing diabetic foot ulcers are a common cause of amputation. Emerging cellular therapies such as platelet-rich plasma gel provide ulcer management options to avoid loss of limb. The purpose of this prospective, randomized, controlled, blinded, multicenter clinical study was to evaluate the safety and efficacy of autologous platelet-rich plasma gel for the treatment of nonhealing diabetic foot ulcers. One hundred, twenty-nine (129) patients were screened; 72 completed a 7-day screening period and met the study inclusion criteria. Patients were randomized into two groups - the standard care with platelet-rich plasma gel or control (saline gel) dressing group - and evaluated biweekly for 12 weeks or until healing. Healing was confirmed 1 week following closure and monitored for another 11 weeks. An independent audit led to the exclusion of 32 patients from the final per-protocol analysis because of protocol violations and failure to complete treatment. In this group, 13 out of 19 (68.4%) of the platelet-rich plasma gel and nine out of 21 (42.9%) of the control wounds healed. After adjusting for wound size outliers (n = 5), significantly more platelet-rich plasma gel (13 out of 16, 81.3%) than control gel (eight out of 19, 42.1%) treated wounds healed (P = 0.036, Fisher's exact test). Kaplan-Meier time-to-healing also was significantly different between groups (log-rank, P = 0.0177). No treatment-related serious adverse events were reported and bovine thrombin used in the preparation of PRP did not cause Factor V inhibition. When used with good standards of care, the majority of nonhealing diabetic foot ulcers treated with autologous platelet-rich plasma gel can be expected to heal.     

Leucocyte- and platelet-rich fibrin (L-PRF) as a regenerative medicine strategy for the treatment of refractory leg ulcers: a prospective cohort study

Chronic wounds (VLU: venous leg ulcer, DFU: diabetic foot ulcer, PU: pressure ulcer, or complex wounds) affect a significant proportion of the population. Despite appropriate standard wound care, such ulcers unfortunately may remain open for months or even years. The use of leukocyte- and platelet-rich fibrin (L-PRF) to cure skin ulcers is a simple and inexpensive method, widely used in some countries but unknown or neglected in most others. This auto-controlled prospective cohort study explored and quantified accurately for the first time the adjunctive benefits of topical applications of L-PRF in the management of such refractory ulcers in a diverse group of patients. Forty-four consecutive patients with VLUs (n = 28, 32 wounds: 17 ≤ 10 cm² and 15 > 10 cm²), DPUs (n = 9, 10 wounds), PUs (n = 5), or complex wounds (n = 2), all refractory to standard treatment for ≥3 months, received a weekly application of L-PRF membranes. L-PRF was prepared following the original L-PRF method developed more than 15 years ago (400g, 12 minutes) using the Intra-Spin L-PRF centrifuge/system and the XPression box kit (Intra-Lock, Boca Raton, FL, USA; the only CE/FDA cleared system for the preparation of L-PRF). Changes in wound area were recorded longitudinally via digital planimetry. Adverse events and pain levels were also registered. All wounds showed significant improvements after the L-PRF therapy. All VLUs ≤ 10 cm², all DFUs, as well as the two complex wounds showed full closure within a 3-month period. All wounds of patients with VLUs > 10 cm² who continued therapy (10 wounds) could be closed, whereas in the five patients who discontinued therapy improvement of wound size was observed. Two out of the five PUs were closed, with improvement in the remaining three patients who again interrupted therapy (surface evolution from 7.35 ± 4.31 cm² to 5.78 ± 3.81 cm²). No adverse events were observed. A topical application of L-PRF on chronic ulcers, recalcitrant to standard wound care, promotes healing and wound closure in all patients following the treatment. This new therapy is simple, safe and inexpensive, and should be considered a relevant therapeutic option for all refractory skin ulcers.     

Evaluation of the efficacy of platelet-rich plasma on healing of clean diabetic foot ulcers: A randomized clinical trial in Tehran,Iran

Background and aimsDiabetic foot ulcers (DFUs) are among challenging hurdles both for the patient and the physician. There is a recent trend toward finding novel and clinically efficient modalities to treat this potentially hazardous complication of diabetes mellitus in a timely manner. Herein, we aim to appraise the efficacy of platelet-rich plasma (PRP) in healing of clean DFUs.Methods90 patients with clean DFUs consisting of 56 (62.2%) males and 34 (37.8%) females with mean age (±standard deviation) of 56.52 (±7.14) years were enrolled in this study between June 2017 and December 2018. They were randomly allocated into control group (47 patients who received conventional dressing along with silver sulfadiazine ointment twice daily), and case group (43 patients who received PRP gel twice weekly for 3 weeks). All the patients were followed up for 6 months.ResultsOur study showed that PRP significantly increased the healing rate of DFUs regardless of the age (p-value: 0.0), gender (p-value: 0.0), or smoking (p-value: 0.0) and blood pressure (p-value: 0.0) status of patients, but it did not have a significant impact on the need for amputation (p-value: 0.11), level of amputation (p-value: 0.16), or the need for further treatments such as graft or angioplasty (p-value: 0.52).ConclusionRegardless of the age, gender, or smoking and blood pressure status of patients, PRP can be efficiently used in diabetic patients to accelerate the healing rate of foot ulcers.     

Efficacy of autologous platelet-rich plasma use for arthroscopic meniscal repair: A randomized trial protocol

Background:Meniscus tear is one of the most familiar orthopedic injury, and it is also the leading cause of the dysfunction of knee joint. Recent efforts to improve the success rate of the meniscus repair surgery involve the addition of platelet-rich plasma (PRP). The aim of our experiment is to assess the clinical effects of arthroscopic repair of meniscal tears without or with PRP.Methods:This is a randomized and parallel-group superiority study. The study protocol is approved through the review committee of the corresponding institutions in PLA Army 80th Group Military Hospital. All patients will provide written informed consent to participate in the study. We implement our investigation on the basis of the ethical standards outlined in the Helsinki Declaration of 1964 and then report our outcomes according to the CONSORT statement of 2010. All the patients follow a same rehabilitation program. Patients are assessed at baseline (day before operation), 12 months and 24 months after the last time of injection; outcome assessments involve Ikeuchi score, Lysholm score, and the visual analogue scales for failure and pain rate. P value less than .05 indicates that there is statistical significance.Results:We suppose that arthroscopic PRP repair of meniscus tears results in improved pain and functional results owing to the release of bioactive molecules that may affect the healing of meniscus.Trial registration:This study protocol was registered in Research Registry (researchregistry6175).     

A clinico-pathological study of diabetic foot ulcers

During a 32-month period 94 foot ulcers in 54 diabetic patients aged 38-90 years (mean 64 years) were managed in a specialist foot clinic. Fifty-six percent were men, and they were significantly younger than women; 46% were taking insulin. Mean duration of diabetes was 13.4 years. Comparison with controls revealed a higher prevalence (p less than 0.01) of retinopathy (60% vs 23%), neuropathy (89% vs 31%), vasculopathy (71% vs 34%), arterial calcification (31% vs 20%) and previous lesions (54% vs 4%). There was no difference in quality of diabetic control, or smoking habit. A simple classification of lesions was used. All types yielded mixed cultures of microorganisms (average 2.1 per swab); the flora obtained was affected by systemic antibiotics. Abnormal pressure was judged to have contributed to all lesions occurring in areas of callus. In addition definable trauma precipitated the event in up to 60% of all other types. Lesions in areas of callus were more likely to have healed by the end of the study period, but average time to healing was significantly longer than other lesions. Despite intensive outpatient support, 33 patients spent a total of 1188 days in hospital during the 974 day period, an average of 36 days per patient and 1.2 beds per day. Further research is urgently required to define optimal methods of prevention and treatment of diabetic foot ulcers.