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

机译：白细胞和血小板和血小板的纤维蛋白（L-PRF）作为治疗难治性腿部溃疡的再生医学策略：一个未来的队列研究

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摘要

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 cm(2) and 15 10 cm(2)), 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 cm(2), all DFUs, as well as the two complex wounds showed full closure within a 3-month period. All wounds of patients with VLUs 10 cm(2) 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 cm(2) to 5.78 +/- 3.81 cm(2)). 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.
机译：慢性伤口（VLU：下肢静脉性溃疡、DFU：糖尿病足溃疡、PU：压疮或复杂伤口）影响着相当大比例的人群。尽管有适当的标准伤口护理，不幸的是，这种溃疡可能会持续数月甚至数年。使用富含白细胞和血小板的纤维蛋白（L-PRF）治疗皮肤溃疡是一种简单且廉价的方法，在一些国家广泛使用，但在大多数其他国家未知或被忽视。这项自动控制的前瞻性队列研究首次准确地探索和量化了局部应用L-PRF在不同患者群体中治疗此类难治性溃疡的辅助益处。连续44例VLUs患者（n=28，32处伤口：17；=10厘米（2）和15；10厘米（2））、DPU（n=9,10处伤口）、脓液（n=5处）或复杂伤口（n=2处），均对标准治疗难治性；=3个月后，每周使用L-PRF膜。L-PRF是按照15年前开发的原始L-PRF方法（400g，12分钟）制备的，使用的是旋内L-PRF离心机/系统和XPression box试剂盒（美国佛罗里达州博卡拉顿Intra Lock；唯一经CE/FDA批准的制备L-PRF的系统）。通过数字求积仪纵向记录伤口面积的变化。还记录了不良事件和疼痛程度。在L-PRF治疗后，所有伤口都有显著改善。所有VLU；=10厘米（2），所有DFU以及两个复杂的伤口在3个月内完全闭合。VLUs患者的所有伤口；继续治疗（10处伤口）的10 cm（2）患者可以闭合，而在停止治疗的5名患者中，观察到伤口大小的改善。五例脓液中有两例闭合，其余三例再次中断治疗的患者情况有所改善（表面演变从7.35+/-4.31 cm（2）到5.78+/-3.81 cm（2））。未观察到任何不良事件。局部应用L-PRF治疗慢性溃疡，不符合标准伤口护理，可促进治疗后所有患者的愈合和伤口闭合。这种新疗法简单、安全、廉价，应被视为所有难治性皮肤溃疡的相关治疗选择。

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