Clinical observation of platelet-rich fibrin combined with the propeller skin flap of the posterior tibial artery perforating branch in the treatment of soft tissue defects in the lower limb
LIANG Feiteng
LI Shuxiao
WEI Xuehan
LU Liu
TANG Qiang
Abstract：Objective To compare and analyze the effects of platelet-rich fibrin(PRF)combined with posterior tibial artery per-forator propeller flap and posterior tibial artery perforator flap alone on the healing process,healing factors and wound outcome of lower limb soft tissue defects.Methods A retrospective cohort study was conducted,selecting 105 patients with lower limb soft tissue defects treated at the Affiliated Hospital of Youjiang Medical University for Nationalities from January 2020 to March 2023 for observational research.Based on different treatment methods,the patients were divided into a control group of 53 cases(using the posterior tibial artery perforator propeller flap)and an observation group of 52 cases(using PRF in conjunction with the posterior tibial artery perforator propeller flap).The survival of the flaps,occurrence of complications,flap size,number of dressing changes,and the wound healing process were compared be-tween the two groups.Additionally,the preoperative and postoperative pain levels(visual analogue score,VAS),the levels of healing factors in the drainage fluid from the wounds,and functional outcomes were assessed.Results Both groups of patients successfully preserved their limbs,with all flaps surviving and no vascular crises occurring.The incidence of necrosis at the flap margins in the observation group(0)was lower than that in the control group(11.32%),with P<0.05.The observation group had fewer dressing changes,shorter wound heal-ing times,and shorter hospital stays compared to the control group(P<0.05).The VAS scores for the observation group at postoperative days 3,5,10,and 15 were(3.78±0.44),(2.68±0.51),(1.83±0.37),and(0.81±0.17)respectively,which were significantly lower than the control group's scores of(4.30±0.59),(3.24±0.69),(2.09±0.42),and(1.35±0.31)(P<0.05).At postoperative day 5,the levels of basic fibroblast growth factor,vascular endothelial growth factor,transforming growth factor-β1,and platelet-derived growth factor in the obser-vation group were(16.78±2.67)pg/ml,(3.08±0.74)pg/ml,(0.56±0.11)pg/ml,and(28.03±4.27)pg/ml respectively,significantly higher than those in the control group at(13.19±2.55)pg/ml,(2.03±0.56)pg/ml,(0.41±0.09)pg/ml,and(20.79±5.56)pg/ml(P<0.05).There was no statistically significant difference in the comparison of functional prognosis rates between the two groups(P>0.05).Conclusion The effects of two treatment plans for patients with lower limb soft tissue defects are comparable in terms of flap survival rates and functional prognosis.However,the use of PRF treatment can significantly reduce the frequency of dressing changes,shorten wound healing time and hospital stay,and alleviate pain levels,likely related to the modulation of healing factor expression.
Keywords：Lower soft tissue defectPlatelet rich fibrinPropeller flap with perforating branch of posterior tibial artery in the low-er legWound healingPrognosisPain intensity
Publication Date：2025-06-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 362-365,384 )