关键词: 胸壁窦道；富血小板血浆凝胶；负压封闭引流

Abstract: Objective To investigate the clinical effect of platelet-rich plasma gel (APG) combined with vacuum sealing drainage (VSD) in the treatment of patients with sinus of thoracic wall. Methods A total of 89 patients with sinus of thoracic wall who were admitted to the department of plastic surgery of the hospital between October 2019 and March 2021 were selected as the research subjects. They were divided into observation group (n=45) and control group (n=44) by random number table method. The control group was treated with VSD, and the observation group was treated with APG combined with VSD. The healing of sinus of thoracic wall was compared between the two groups. Results The curative effect was significantly different in the two groups (97.78% vs. 86.36, P<0.05). The sinus closure time, wound healing time and hospital stay of observation group [(15.26±2.33) d, (25.19±3.54) d and (41.26±5.33) d] were significantly shorter than those of control group [(27.26±3.05) d, (43.26±5.17) d and (58.64±6.11) d] (P<0.05). The rate of secondary repair surgery and recurrence rate of sinus tract in observation group (0 and 0) were lower than those in control group (11.36% and 13.64%) (P<0.05). After treatment, C-reactive protein (CRP), white blood cell count (WBC), tumor necrosis factor (TNF-α) and Visual Analogue Scale (VAS) in the observation group [(20.36±3.41) mg/L, (5.23±0.64) ×109, (15.26±3.24) pg/mL and (1.23±0.25)] were significantly lower than those in the control group [(26.54±3.57) mg/L, (8.17±0.93)×109, (24.16±3.94) pg/mL and (3.04±0.41)] (P<0.05). 1w and 2w after treatment, the positive rates of bacterial culture in observation group (37.78% and 11.11%) were lower than those in control group (59.09% and 29.55%) (P<0.05). The Vancouver Scar Scale (VSS) of observation group at 1 month and 2 months after wound healing [(7.33±0.85) and (3.26±0.41)] were significantly lower than those of control group [(8.64±0.91) and (5.14±0.62)] (P<0.05). The incidence of adverse reactions in observation group (8.89%) was significantly lower than that in the control group (25.00%) (P<0.05).Conclusion APG combined with VSD can promote the recovery of sinus tract in patients with sinus of thoracic wall, with good antibacterial effect. In addition, it can relieve pain and scar hypertrophy, and reduce adverse reactions.

Key words: sinus of thoracic wall; platelet-rich plasma gel; vacuum sealing drainage