Search

OBJECTIVE: To show analysis of the results of applying the method platelet-rich plasma (PRP) for the treatment of problematic skin wounds. The paper’s objective is to prove its reliability and relevance, to evaluate its efficiency and applicability to Bulgarian patients. MATERIAL AND METHODS: Out of a total of 154 hospitalized patients with problematic skin wounds 83 have been treated with platelet-rich plasma, comprising the Experimental group (EG), and 71 patients with similar wounds have been treated by using traditional methods for the respective pathology at the Department of Orthopedics and Traumatology, Vessel and Plastic Surgery Department, comprising the Control Group (CG). Data on the condition of monitored symptoms of researched cases was collected for the research. A variable is defined for every symptom and its value and weight is correspondingly introduced. Scores introduced by Cancela AM are used for the assessment of the respective wound. Each of these scores is used for assessing specific wound parameters: Total Wound Score (TWS); total anatomic score (TAS) of wound and Total Score of Wound data (TSWD). RESULTS: Analysis of variance was performed to achieve the objectives and solve the research tasks; variables containing information on initial and final data from each series of experiments have been analyzed in order to determine basic numerical characteristics of variables, and by comparative analysis to check how they tend to vary in experimental (EG) and control (CG) group. Statistical survey shows that the platelet-rich plasma method gives significant results when treating problematic skin wounds leading to full recovery as compared to traditional methods typical for the pathology. The graphical interpretation allows to identify forecast relations between assessed aspects of problematic wounds and weeks of treatment. CONCLUSION: By analyzing the results of our study we can conclude that the use of platelet-rich plasma to treat problematic skin wounds is a safe and effective treatment method. It is not universal for every wound, but follows the principles of biological wound treatment and leads to full recovery of high percentage of problematic skin wounds. We support proponents of the application of platelet-rich plasma to treat problematic skin wounds.

PURPOSE: To find out the PRP application effects in TKA on pain syndrome, wound healing, postoperative blood loss, range of motion and the knee circumference (centimetry). MATERIAL AND METHOD: The preparation of the platelet-rich plasma is based on our treatment algorithm. 20 patients have been subject to TKA within the period from October 2012 to November 2014 and underwent TKA, as platelet rich plasma was used intraoperatively. The average patient age is 72,3; 9 male and 11 female patients. Control group consisted of 17 patients, who underwent surgery in the same period but no platelet rich plasma was used during surgery. Average patient age 73,1; 8 male and 9 female patients. RESULTS: The following results have been reported for the PRP group of patients: the average amount of blood in the aspiration drainage tube in 24 hours - 285 ml.; postoperative pain on the 1st postoperative day was - 7 p., on the 5th day - 5 p., on the 10th day - 2 p., average circumference (centimetry) of the knee between the 1st and the 10th postoperative day decreased on average by 1,5-2 cm., range of motion – reported average degrees per patient on the 1st postoperative day in sagittal plane: 0-10-20 degrees; on the 10th postoperative day: 0-0-55 degrees, surgical wounds of all patients healed primarily without any complications. No PRP group: average amount of blood in the aspiration drainage in 24 hours – 300 pl., postoperative pain on the 1st, 5th , and 10th postoperative day - 8 p., on the 5th day - 6 p., on the 10th day - 3 p., average knee circumference (centimetry) between 1 and 10 postoperative day has decreased by 1 cm on average, range of motion - reported average degrees per patient on the 1st postoperative day in sagittal plane 0-5-20 degrees, on the 10th: 0-0-50 degrees, surgical wounds healed primarily without any complications in 10 patients, but in 7 patients we observed superficial wound edge skin necrosis. CONCLUSION: Our results unequivocally show that platelet-rich plasma reduces postoperative blood loss and the use of narcotics, improves the range of motion and the circumference of the operated joint and it is crucial for the most common postoperative complications of TKA: namely dermal wound problems.

The number of orthopedic surgeons who are convinced in the need for significant changes in planned total knee arthroplasty (TKA) is increasing slowly and steadily. A new approach to pain control has been developed over the past 10-15 years, and the introduction of techniques to reduce perioperative stress, and the use of minimally invasive surgical techniques can help limit postoperative complications and shorten recovery time. This type of optimization is regarded as Fast-track Care program, where improved healing process is particularly useful to comorbid patients.