[Clinical effects of Meek skin grafting combined with platelet-rich plasma in repairing extensive deep burn wounds]

[Meek皮肤移植联合富血小板血浆治疗大面积深度烧伤创面的临床疗效]

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Abstract

OBJECTIVE: To investigate the clinical effects of Meek skin grafting combined with platelet-rich plasma (PRP) in repairing of extensive deep burn wounds. METHODS: This study was a retrospective observational study. From August 2018 to August 2023, 44 patients who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 23 males and 21 females. Their age ranged from 22 to 62 years and the total burn area was 30%-80% total body surface area, the burns on limbs or torso were deep partial-thickness to full-thickness. According to the treatment process of deep burns on the limbs or torso, the patients were divided into observation group (21 cases) and control group (23 cases). patients in observation group were treated with Meek skin grafting combined with PRP at the same time, while patients in control group were treated with Meek skin grafting alone. The survival of Meek skin grafts was observed on the 10(th) day after operation. The wound healing rate in the operation area of patients was observed on the 14(th) day after operation. The postoperative wound healing time and positive rate of bacterial culture of wound secretion specimens were recorded. RESULTS: On the 10(th) day after operation, the skin grafting area of patients in observation group were dry, and the skin grafts adhered closely to the wound base with ruddy color, with a survival rate of (89±4)%; whereas in control group, some of Meek skin grafts fell off in the skin graft area, and the residual wounds were scattered in irregular map shape, accompanied by purulent secretions. The survival rate of skin grafts was (79±6)%, which was significantly lower than that in observation group (t=6.72, P < 0.05). On the 14(th) day after operation, 19 patients in observation group had complete wound healing in the operation area, and the other 2 patients had small residual wounds, which healed after 1 week delay through dressing changes; in control group, the wounds in 12 patients healed completely, the wounds in 6 patients healed after supplementary stamp skin grafting, and the wounds in 5 patients healed with delay after routine dressing changes. The wound healing rate was significantly lower than that in observation group (P < 0.05). After operation, the wound healing time of the operation area of patients in observation group was (13.3±1.6) days, which was significantly shorter than (16.4±3.5) days in control group (t=3.72, P < 0.05); there was no statistically significant difference in the positive rate of bacterial culture of wound secretion specimens between observation group and control group after operation (P > 0.05). CONCLUSIONS: Compared with Meek skin grafting alone, Meek skin grafting combined with autologous PRP can promote the survival of skin grafts, accelerate the expansion and fusion of skin grafts, and shorten the wound healing time, thereby improving the therapeutic effect in the repairing of extensive deep burn wounds.

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