Platelet-rich gel in repair of skull-exposed wounds
Objective To investigate the clinical outcome of platelet-rich gel (PRG) prepared using the one-step centrifugation method in the treatment of scalp defects combined with skull-exposed wounds. Methods From Sep. 2018 to Mar. 2022,14 patients with scalp defects accompanied by skull exposure admitted to Chongqing Emergency Medical Center were enrolled. There were 12 males and 2 females,aged 43-86 years(mean 62.8 years).The wound size ranged from 3.0 cm×4.0 cm to 7.0 cm×6.0 cm,which failed to heal after 4 weeks of conventional treatment. Venous blood was collected from the patients,and PRG was prepared using the one-step centrifugation method. Before treatment,routine scalp debridement was performed. After that,the PRG was directly applied to the surface of the wound. The gel surface was covered with oil gauze,and the outermost layer was sealed with a hydrogel dressing. The PRG was replaced every 3 days until the wound completely healed. The length of the PRG was meas-ured,and the change in platelet concentration was assessed. Additionally,the visual analog scale(VAS) scores,white blood cell (WBC) count,C-reactive protein (CRP),procalcitonin (PCT) levels,and local skin temperature were measured before and 3 days after treatment. Results The length of the PRG prepared by the one-step centrif-ugation method was measured to be (3. 09±0. 09) cm,and the platelet concentration was increased by (2. 43±0.07) folds. After 5-14 times of autologous PRG treatment,all the 14 patients achieved complete healing. The aver-age frequency of treatment was 8.9±2.4 and the wound healing time was (26.8±7.2) d. There were no significant differences observed in VAS scores,WBC count,CRP levels,PCT levels,and topical skin temperature of the wounds before and after treatment. Conclusion PRG can be successfully prepared using a one-step centrifugation method with a vacuum negative pressure tube. Moreover,it has been demonstrated to effectively promote the healing of scalp defects in combination with skull exposure.