The efficacy and safety of platelet-rich plasma in the tendon-exposed wounds: a preliminary study

Abstract

Objective: Currently, among wounds with large skin tissue defects caused by various reasons, the treatment of refractory wounds is still a major clinical problem. This study is aimed to preliminarily assess the therapeutic potentials of platelet-rich plasma (PRP) in refractory wounds with exposed tendons, as well as corresponding efficacy and safety.

Methods: A total of 12 patients (5 males and 7 females) with refractory wounds and exposed tendons who were admitted to our hospital from June 2018 to December 2020 were included in this study. After the preparation of PRP, the included patients underwent the PRP injection after the debridement of wounds, and the efficacy and prognosis were assessed by the same group of senior surgeons.

Results: The average age of included patients was 42.7 ± 12.9 years, and the causes of injury included traffic accidents (3 cases), contusion (2 cases), burns (2 cases), diabetes complications (4 cases), and melanoma complications (1 cases). The average healing time was 23.0 ± 5.0 days, and the mean size of the wound was 3.1 × 5.1 cm². During the whole treatment process, Vancouver Scar Scale (VSS) decreased from 7.4 ± 1.6 before PRP treatment to 3.6 ± 0.9 after treatment (P < 0.001), Manchester Scar Scale (MSS) decreased from 12.3 ± 4.5 before PRP treatment to 5.4 ± 1.2 after treatment (P < 0.001), and no redness and swelling were observed around wounds, the size and degree of wounds gradually reduced, the coverage rate of granulation tissue was acceptable, overall quality of scar was relatively good, skin sensitivity around wounds was normal, there was no local wounds secretion, and postoperative patient's satisfaction was relatively good during follow-up.

Conclusions: Our study has preliminarily indicated that PRP can promote the wounds healing, reduce the inflammation around wounds, and improve the granulation tissue and angiogenesis, thereby effectively polishing up the safety and efficacy.

Keywords: Platelet-rich plasma; Refractory wound; Skin flap transplantation; Tendon-exposed wounds.

Fig. 1

Specific steps of the injection of PRP in refractory wounds with exposed tendons. A The appearance of refractory wounds with exposed tendons; B–D The injection of PRP in refractory wounds with exposed tendons

Fig. 2

Situation and treatment process of the patient with refractory wounds with exposed tendons. A The growth of granulation tissues around tendon was found on the 4th day after the operation; B The granulation tissues covered all wounds except tendon on the 5th day; C The granulation tissue began to cover the partial tendon on the 6th day; D During the second operation, it was observed that the blood supply of the wounds was abundant; E The whole wounds were covered with granulation tissue, and the wound area reduced to 3.8 cm × 2.6 cm on the 5 days after the second operation; F The condition after wound healing