Experimental study of negative pressure wound therapy combined with platelet-rich fibrin for bone-exposed wounds

Aim: To evaluate the efficacy of negative pressure wound therapy (NPWT) combined with platelet-rich fibrin (PRF) in treating bone-exposed wounds and explore its possible mechanism. Materials & methods: A bone-exposed wound was created in a total of 32 healthy Sprague-Dawley rats, which were treated with either control, NPWT group, PRF group or both (N + P group). The bone-exposed area, skin contraction rate and granulation coverage and the level of growth factors in granulation tissue were determined on days 4, 7 and 10. Results: The N + P group showed significantly higher wound closure rate than that achieved with others respectively. Four factors were significantly higher in N + P group than in the other three groups. Conclusion: Combination of NPWT and PRF can repair bone-exposed wounds effectively and accelerate wound healing. Lay abstract Wounds with exposed bone are refractory, and are usually caused by mechanical trauma, burns, infections, pressure ulcers, diabetic illness and tumor resection. Surgery is the most effective way to cover such wounds. However, repairing defects with local or distal skin flaps can cause potential donor site damage. Skin grafting might be a simpler method, but the avascular interface of bone makes granulation tissue difficult to grow, thus transplanting skin on exposed bones is contraindicated. There is growing interest in identifying alternative treatment strategies. In this study, our goal is to use platelet-derived fibrin in combination with negative pressure wound therapy to determine whether this combined strategy can achieve mesenchymal healing with granulation tissue to treat bone exposed wounds. The results of wound healing in the negative pressure wound therapy and platelet-rich fibrin combined treatment group were better than those of other treatment groups. The combined treatment strategy of platelet-derived fibrin and negative pressure wound therapy can repair bone-exposed wounds effectively, accelerate wound healing and is a promising therapeutic option for bone exposed wounds.