Lower extremity ulcers in diabetic patients are difficult to treat. Recently, the use of human blood platelet-derived components in this indication has been raising interest. In this study, we have evaluated the safety and efficacy of the combination of autologous platelet gel (PG) and skin graft for treating large size recalcitrant ulcers. Eight consecutive diabetic patients aged 25 to 82 with nine nonhealing lower extremity ulcers (median size of 50 cm2; range 15–150 cm2) were treated. Skin ulcer was debrided, and the wound was sprayed after 7 to 10 days with autologous platelet-rich plasma and thrombin. Thin split-thickness skin graft with multiple slits was then applied on the wound bed and fixed with staples or cat-gut sutures. There were no adverse reactions observed during the study. Eight out of 9 skin grafts took well. The interval between skin graft and complete wound healing ranged from 2 to 3 weeks in the 8 successful cases. No ulcer recurrence was noted in those patients during the follow-up period of 2 to 19 months. In this study, the combination of autologous platelet gel and skin grafting has proven beneficial to heal large-size recalcitrant ulcers.
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机译：糖尿病患者的下肢溃疡很难治疗。最近，在这种适应症中使用人血小板衍生的成分引起了人们的兴趣。在这项研究中，我们评估了自体血小板凝胶（PG）和皮肤移植物联合治疗大尺寸顽固性溃疡的安全性和有效性。治疗了8例年龄在25至82岁之间的糖尿病患者，其中9例下肢溃疡未愈合（中位大小为50 cm 2 ；范围为15-150 cm 2 ）。清创皮肤溃疡，并在7至10天后用自体富含血小板的血浆和凝血酶喷雾伤口。然后将具有多个缝隙的薄裂厚皮肤移植物应用于伤口床上，并用吻合钉或肠线缝合固定。在研究过程中未观察到不良反应。 9个植皮中有8个恢复良好。在8例成功病例中，植皮与完全伤口愈合之间的间隔为2至3周。在2到19个月的随访期间，这些患者均未发现溃疡复发。在这项研究中，自体血小板凝胶和皮肤移植的结合已被证明对治愈大型顽固性溃疡有益。
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