目的

探讨在系统性红斑狼疮（SLE）的患者皮肤溃疡的治疗中，凝胶状富血小板血浆（PRP）的处理流程及使用效果。

方法

收集徐州仁慈医院创面修复科2017 年9 月至2024 年9 月收治的SLE 伴体表溃疡患者35 例，均为女性；平均年龄32（25～53）岁，入院前溃疡持续时间1 周～7 个月。 溃疡形成原因：32 例为伤口因磕碰致皮肤破损后创面扩大形成溃疡；1 例为中指再造后甲瓣供区皮瓣修复坏死、创面不愈合；2 例臀部创面为自行破溃所致。 入院时伤口面积2.0 cm×3.5 cm～7 cm×7 cm，创面均无骨、肌腱外露。 入院后予以全身情况评估，风湿免疫科专科会诊调整SLE 治疗用药。皮肤溃疡手术清创后以PRP 凝胶覆盖创面促进创基肉芽生长及表皮上皮化； 同时，创面治疗以新型创面敷料按湿性愈合理论换药。

结果

35 例患者按本研究方案进行治疗，未行植皮或皮瓣修复等其他手术覆盖创面，伤口均顺利愈合。

结论

在SLE 患者的溃疡治疗中，外科手术清创后外用PRP 凝胶覆盖创面，创面基底肉芽生长速度快，后续以新型敷料换药处理，疗效显著，且操作难度相对较低，费用低廉，易在临床推广。

Objective

To investigate the preparation process and clinical effect of gel platelet-rich plasma （PRP）in the treatment of skin ulcer in patients with systemic lupus erythematosus（SLE）.

Methods

A total of 35 female patients with systemic lupus erythematosus （SLE） accompanied by superficial ulcers，admitted to Department of Wound Repair，Xuzhou Renci Hospital from September 2017 to September 2024，were enrolled.The average age was 32 years （range 25-53 years）， and the duration of ulcers before admission ranged from 1 week to 7 months.The causes of ulcer formation were as follows.In 32 cases， the ulcers developed due to skin abrasions causedby trauma，which subsequently expanded into larger wounds.In 1 case， the ulcer resulted from necrosis and non-healing of the flap at the donor site of a hallux toenail flap used for middle finger reconstruction.And in 2 cases， the ulcers on the buttocks were caused by spontaneous rupture.On admission， the wound area ranged from 2.0 cm×3.5 cm to 7 cm×7 cm， with no exposed bones or tendons observed on the wound surface.After admission， a systemic condition assessment was performed，and rheumatology specialists were consulted to adjust the SLE treatment regimen.Following surgical debridement of the skin ulcers， the wound surface was covered with PRP gel to promote granulation tissue growth and epidermal epithelialization.Simultaneously， the wounds were treated with advanced wound dressings according to the moist wound healing theory.

Results

All 35 patients were treated according to the study plan， without skin grafting or flap repair or other operations covering the wound surface， and the wounds healed smoothly.

Conclusion

In the treatment of ulcers in patients with SLE after surgical debridement， platelet-rich plasma gel is applied to cover the wound surface， and the growth rate of granulation tissue at the wound base is rapid.Subsequently， new dressings are used for wound care，demonstrating significant therapeutic efficacy.This treatment has relatively low surgical difficulty and cost，making it easy to popularize in clinical practice.