Objective To study the effect of platelet-rich plasma (PRP) on repairing chronic wounds of lower l imbs. Methods From May 2007 to November 2007, 47 patients suffering from chronic wounds of lower l imbs were treated. There were 41 males and 6 females, aged from 15 to 68 years (43.2 years on average). The disease was caused by tibiofibulafracture in 20 cases, calcaneus fracture in 4 cases, metatarsal fracture in 1 case, multiple open fracture of lower l imbs in 3 cases, tibia osteomyel itis in 10 cases, femur osteomyel itis in 1 case, soft tissue injury of ankle in 4 cases, infection after amputation in 2 cases, infection after foot orthomorphia in 1 case, and infection after calcaneus tendon neoplasty in 1 case. Their chronic wounds did not healed after 2 to 4 months of therapy. Among them, chronic wounds compl icated with fracture nonunion in 23 cases and positive bacterial culture result in 38 cases. Debridement and autogenous PRP gel injection were appl ied every 2 months and for twice. Results The patients were followed up for 4 months after the first PRP injection. Two months after the first PRP injection, chronic wounds contracted significantly in 34 patients with purulence and necrosis tissue cleaned up, circulation of soft tissue improved and exposed bone or muscle tissue covered by neogenetic granulation. No patient was completely cured. Two months after the second PRP injection, the average coverage rate was 79.3% ± 18.0%, the total cure rate was 29.8%. The volume of the chronic wounds decreased by (9.3 ± 4.9) mL after PRP therapy (2.5 ± 2.7) mL when compared with (11.8 ± 5.6) mL of before therapy, showing significant difference (P lt; 0.05). X-ray photograph showed that among the 23 cases of fracture nonunion, fracture healed completely in 9 cases; bony callus formation increased obviously in 12 cases; no significant change was observed in 2 cases. No aggravated sign of osteomyel itis was notified. Positive results of bacterial culture reduced to 15 cases. Conclusion PRP efficiently enhances the recovery of soft tissue defect and speeds up the chronic wounds heal ing oflower l imbs.
Objective To investigate the effect of PRP in improving bone repair so as to provide an experimental basis for repairing bone defect. Methods From January 2007 to March 2007, 59 cases of fresh fracture were treated with PRP(PRP group, n=29) and with conventional open reduction and fixation(control group, n=30). In PRP group, there were 19 males and 10 females, aging 18-57 years(mean 43.62 years), including 8 cases of femural fracture, 12 cases of tibio-fibula fracture,2 cases of humeral fracture, 3 cases of ulna and radia fracture, 2 cases of fracture in extremity and 2 cases of claviclar fracture. In control group, there 19 males and 11 females, aging 22 to 57 years (mean 35 years), and including 7 cases of femural fracture, 9 cases of tibio-fibula fracture, 5 cases of humeral fracture, 7 cases of ulna and radia fracture, 1 case of fracture in extremity and 1 case of claviclar fracture. All patients were admissioned within 24 hours after injury. The time from hospital ization to operation was 24 to 48 hours(mean 36 hours). There were no statistically significant differences in the common data between two groups (P gt; 0.05). The degree of inflammatory reaction of wounds, the grade of wounds heal ing and the hospital ization days were observed and analysed statistically. Results At 5 days after operation, no inflammatory reaction was observed in 22 cases of RPR group and in 17 cases of control group, mild inflammatory reaction in 6 cases of RPR group and in 8 cases of control group, moderate inflammatory reaction in 1 case of RPR group and in 3 cases of control group, and serious inflammatory reaction in 2 case of control group, showing no statistically significant differences (P gt; 0.05). Wound healed by first intention in 29 patients of RPR group and in 29 patients of control group (29/30), by second intention after 3 days of dressing change in 1 patient of control group; showing no statistically significant differences (P gt; 0.05). The hospital ization days were (8.21 ± 1.52) days in RPR group and (11.67 ± 1.48) days in control group, showing statistically significant differences (P lt; 0.05). All patients of two groups were followed up 6-12 months (mean 10 months). The X-ray films at follow-up showed that bony heal ing was achieved within 6-8 months in RPR group and within 8-10 months in control group, showing no statistically significant differences (P gt; 0.05). Conculsion Using PRP can speed up the heal ing of operative incision with no adverse effect, shortenthe hospital ization days.