Abstract

HERNANDEZ, I. et al. Pratical use of autologous fibrin in repartive medicine and plastic surgery. Cir. plást. iberolatinoam. [online]. 2014, vol.40, n.3, pp.345-357. ISSN 1989-2055.  https://dx.doi.org/10.4321/S0376-78922014000300016.

Our aim is to determine the clinical efficacy of autologous fibrin in traumas with deeply exposed open wounds; in diabetic foot, and ulcers due to chronic venous insufficiency. The goal was to regenerate the affected tissue and assist in inducing the formation of sufficiently compact granulation tissue, in order to enable auto-skin grafts or facilitate the closure by second intention, when grafts are not able to be used. The most rapid tissue regeneration becomes in a lower morbidity rate, reduction in hospital costs and a better quality of life. We present a clinical prospective study, observational, over time and random with control cases, carried out between October 2011 and November 2013, in a sample of 34 patients that met the inclusion criteria of a total of 84 patients examined. Lesions of 3 different etiologies were studied, all of them located in the lower limbs and that corresponded to trauma wounds with exposure of bone and/or tendons. Ulcers due to chronic venous insufficiency class VI and diabetic foot wounds type II were also included. All patients received autologous fibrin with assistance as outpatients, completing the treatment with the application of paraffin dressings and occlusive bandaging cures were done every 4 days. Controls of treatment and advantages of the technique were carried out on lesions of similar size, deepness and location, in 50 patients that were treated in a conventional way without using fibrin. Lesions that evolved faster were those due to trauma with exposure of bones or other soft tissue, followed by those due to venous insufficiency and lastly, those diabetic foot ones. In those lesions of traumatic origin, the granulation time, in order to incorporate partial auto-skin grafts and/or closure by second intention, was in an average of 72,7% faster when compared to those of the control group (8 weeks difference). Ulcers due to venous insufficiency healed 70,6% faster, with an average of 12 weeks difference with the control group. Diabetic foot wounds healed in an average of 58,3%, with 14 weeks difference with respect to the control group. All patients both consulted externally and those hospitalized due to their serious wound characteristics, were treated as outpatients with no need for any type of anaesthesia. Healing was reduced in an average of 64,7% in comparison to those treated without fibrin. Recovery time, hospital stay and satisfaction as reported by patients with regards to results obtained, was statistically significant p < 0,05. In conclusion, the use of autologous fibrin in lesions of known slow healing and uncertain evolution, decreases recovery time as it induces better wound healing. The use of fibrin helps to obtain better tissue quality, decreases hospital stay and achieves high patient satisfaction with results obtained.

Keywords : Autologous fibrine; Noble tissue; Tendon; Trauma injury; Diabetic foot; Vascular injury; Varicose ulcer; Tissue repair.

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