Observation on efficacy of autologous platelet rich fibrin combined with ultra-pulsed carbon dioxide laser in the treatment of cancellous bone exposed wounds.

This study is to evaluate the effectiveness of autologous platelet-rich fibrin (PRF) combined with ultra-pulsed carbon dioxide laser in treating cancellous bone-exposed wounds. A total of 65 patients with cancellous bone-exposed wounds were retrospectively analyzed selected. There were 35 cases in ultra-pulsed carbon dioxide laser + PRF group (Laser group, group L), and 30 cases in routine surgical debridement + PRF group (Routine group, group R). Parameters compared included the percentage of wound healing at intervals of 4, 8, 12, and 16 days post-treatment, growth status of wound granulation tissue, blood circulation, and pain scores before, during, and after the first debridement. Statistical analyses employed included the independent sample t test, repeated measures analysis of variance, chi-square test/Fisher exact test, Mann-Whitney U test, and Bonferroni correction. At 4, 8, 12 and 16 days after treatment, the wound healing percentages with (14.3% [8.6%, 22.8%], 28.6% [20.0%, 34.3%], 40.0% [34.3%, 54.3%], 62.8% [51.4%, 71.4%]) in group L were significantly higher than (3.3% [0.0%, 10.0%], 6.6% [3.3%, 16.7%], 16.7% [13.3%, 20.0%], 33.3% [23.3%, 46.7%], Z = 2.975, 3.452, 3.849, 4.178, P < .05) in group R. The granulation color observation scores of both groups were increased at 4, 8, 12 and 16 days after treatment, and the above granulation color observation scores in group L were obviously higher than those in group R (t = 6.028, 7.814, 5.209, 8.038, P < .05). Pain scores in group L during and after debridement were significantly lower than those in group R (t = 4.974, 6.740, P < .05). At 4, 8, 12 and 16 days after treatment, the wound blood perfusion volumes were risen in the 2 groups, and at 12 and 16 days after treatment, the wound blood perfusion volumes were significantly higher in group L than those in group R (z = 3.018, 3.247, P < .05). Compared to routine surgical debridement, the combination of PRF with ultra-pulsed carbon dioxide laser significantly enhances the percentage of wound healing, improves the granulation color and blood circulation, and reduces debridement pain in patients with cancellous bone-exposed wounds.