بررسي مقايسه نتيجه درمان زخم دونور پيوند پوست با ضخامت متوسط به روش مرسوم (استفاده از گاز وازلينه) و روش استعمال موضعي پلاسماي غني ازپلاكت

Comparison of the thickening of donor skin graft with conventional method (using vaseline gas) and platelet-rich plasma topical application

فرآيند ترميم زخم شامل سه مرحله مي باشد و در همه اين مراحل براي ترميم زخم نرمال نياز به فعال شدن پلاكت ها، آزادسازي سايتوكين ها و هورمون هاي رشد، كموتاكسي و تمايز سلولي مي باشد. هدف پژوهش حاضر بررسي مقايسه نتيجه درمان زخم دونور پيوند پوست با ضخامت متوسط و روش استعمال موضعي پلاسماي غني از پلاكت مي باشد. روش بررسي در مركز درماني شهر ايلام در بيمارستان امام خميني (ره) تعداد 20 بيماركه داراي دو محل دونور گرافت مشابه بودند، براي شركت در يك كارآزمايي باليني از دي تا اسفند 1395 به تدريج انتخاب شدند. از دو ناحيه داراي محل دونور گرافت پوستي مشابه بيماران يك ناحيه به روش مرسوم (گازوازلين) گرفته شد و ناحيه ديگر با استعمال موضعي پلاسماي غني از پلاكت كه دقيقا پس از جراحي و بعد در روزهاي پنجم، هشتم و يازدهم به صورت موضعي و پس از شستشوي زخم با سرم فيزولوژي بر روي زخم ماليده شد و بدين ترتيب تحت درمان و مقايسه قرار گرفتند و سپس سرعت بهبود زخم به صورت باليني و با استفاده از فتوگرافي بررسي و مقايسه مي شوند. يافته ها پس از جمع آوري زمان هاي بهبود زخم در دو گروه، براي ارزيابي اثر PRP بر روي سرعت بهبود زخم و تحليل نتايج از روش مقايسه كردن ميانگين ها استفاده نموديم Independent samples t-test. چون داده ها از توزيع نرمال پيروي مي كردند از روش Independent samples t-test استفاده كرديم كه نتيجه آن 0/416 شد كه از ميزان آلفاي مساوي با 0/05 بيشتر بود. نتيجه گيري ما در اين مطالعه به اين نتيجه رسيديم كهPRP اثر مثبتي بر روي زمان بهبود زخم داشته و سرعت بهبود زخم را افزايش مي دهد.

Healing involves complex processes that are not yet fully known. The wound healing process consists of three stages. In all these stages, normal wound healing requires platelet activation, release of cytokines and growth hormones, and chemotaxis and cell differentiation. Platelets play a key role in homeostasis and wound healing and growth factor production of more than 30 carried out by them. Platelets regulate the healing process with their chemotactic effect. Antilogous PRP platelet count in about 3 to 5 times increase and consequently also increases the number of growth factors, for this reason, they are being used in surgical procedures and clinical therapy. Methods At Ilam Medical Center in Imam Khomeini Hospital, 20 patients with two similar donor graft sites were gradually selected to participate in a clinical trial from January to March 2017. The two regions have the same skin graft patients, an area of Honor conventional and other areas with the topical administration of platelet-rich plasma That immediately after surgery and in the days after the fifth and eleventh, eightieth and after washing the wound with a topical serum Physiology rubbed on the wound and thus treated The rate of wound healing clinically and using X-ray photo-checked and compared. Results Seven are male and thirteen are female and the age range of patients is between 17 and 67 years. After collecting wound healing times in two groups, we used the means comparison method to evaluate the effect of PRP on wound healing rate and analyzed the results (T-Test). Because the data followed a normal distribution, we used the Independent T-test method, which resulted in 0.416, which was higher than the alpha level equal to 0.05. Conclusion In this study, we found that PRP had a positive effect on wound healing time and increased the speed of wound healing. It is suggested that the effect of the PRP method on various organs that have not been tested before, be discussed in future studies.