To explore the clinical effects of artificial dermis combined with platelet-rich fibrin (PRF) in repairing small area deep wounds.

A prospective randomized controlled study was conducted. From January 2018 to December 2021, 40 patients with small area deep wounds who met the inclusion criteria were admitted to Department of Burns of Zhengzhou First People′s Hospital. According to the block randomization, the patients were divided into two groups, with 20 patients in each group. In artificial dermis group, there were 11 male and 9 female patients, aged (43.10±4.54) years, with the wounds area of (35.85±5.64)cm². In combination group, there were 13 male and 7 female patients, aged (43.55±4.71) years, with the wounds area of (37.65±6.21)cm². After the wound was completely debrided, artificial dermis was used to cover the wound in artificial dermis group, but in combination group, whole venous blood was extracted from patients to prepare PRF for wound packing and the wound was covered with artificial dermis. Then dressing change was conducted regularly. After the growth of granulation tissue covered the wound in both groups, autologous skin grafting was conducted to repair wounds in the second stage. The times of dressing change and wound healing time were recorded. The survival rate of skin flap on the 7th day after autologous skin grafting was calculated. The occurrence of hematoma under artificial dermis and adverse reactions such as wound infection were recorded. At 6 months after wound healing, the patients were followed up to observe whether the skin graft area was ruptured, and the scar was evaluated by Vancouver scar scale (VSS). Data were statistically analyzed with independent sample t test, Mann-Whitney U test, and chi-square test.

The times of dressing change in combination group was (8.65±2.54), significantly less than (10.75±3.16) in artificial dermis group (t=2.316, P<0.05). The wound healing time in combination group was (29.95±4.71) days, significantly shorter than (35.55±5.34) days in artificial dermis group (t=3.520, P<0.05). On the 7th day after autologous skin grafting, the survival rate of skin flap was (92.9±6.9)% in combination group, which was not significantly different from (91.3±8.7)% in artificial dermis group (t=0.645, P>0.05). There were no hematomas under artificial dermis and wound infection occurred in both groups. At 6 months after wound healing, there was no rupture in the skin grafting area of the two groups. The VSS score of the wound was 5.00(4.00, 6.00) in combination group, significantly lower than 6.00(5.00, 6.00) in artificial dermis group (Z=2.422, P<0.05).

Artificial dermis combined with PRF has obvious clinical effects in repairing small area deep wounds. It can significantly reduce the times of dressing change, shorten the healing time, and improve scar hyperplasia.