目的:探讨自体富血小板血浆（PRP）凝胶联合负压封闭引流(VSD)技术修复难愈性创面的临床效果。方法:将2011年3月—2015年1月潍坊市益都中心医院烧伤整形外科收治的44例符合入选标准，进行间歇式VSD治疗的难愈性创面患者患者纳入单纯VSD组，将2015年2月—2019年9月该单位收治的符合入选标准的，进行PRP凝胶和间歇式VSD治疗的43例难愈性创面患者纳入PRP+VSD组，进行回顾性队列研究。单纯VSD组患者中男24例，女20例，年龄（37.5±2.2）岁，PRP+VSD组患者中男25例、女18例，年龄（37.0±2.5）岁。收集2组患者第1次治疗前和治疗后7、14 d的创面分泌物进行细菌培养，并计算细菌培养阳性率。第1治疗后7、14、21 d，观察创面愈合情况并计算创面愈合率，记录2组患者创面完全愈合时间。第1次治疗前和治疗后14 d,采用视觉模拟评分法(VAS)评估2组患者创面疼痛程度。创面完全愈合后1、2个月采用温哥华瘢痕量表(VSS)评估2组患者瘢痕增生情况。观察2组患者术后不良反应的发生情况，并计算不良反应发生率。对数据行重复测量方差分析、n χ2检验、成组n t检验及Bonferroni校正。n 结果:第1次治疗后7、14 d PRP+VSD组患者细菌培养阳性率为37.2%（16/43）、11.6%（5/43），明显低于单纯VSD组的56.8%（25/44）、29.5%（13/44），n χ2=4.212、4.255，n P<0.05。PRP+VSD组患者第1次治疗后7、14、21 d创面愈合率分别为（58±14）%、（70±13）%、（89±12）%，明显高于单纯VSD组的(41±11)%、(60±11)%、(74±12)% ，n t=6.323、3.820、5.751，n P<0.01。PRP+VSD组患者创面完全愈合时间为(30±6)d，明显短于单纯VSD组的(61±8)d，n t=20.89，n P<0.05。PRP+VSD组患者第1次治疗后14 d的VAS评分较单纯VSD组明显降低（n t=13.904，n P<0.01）。PRP+VSD组患者创面愈合后1、2个月VSS评分显著低于单纯VSD组（n t=3.307、3.637，n P<0.01）。PRP+VSD组患者术后不良反应发生率为7.0%（3/43），显著低于单纯VSD组的22.7%（10/44），n χ2=4.245，n P<0.05。n 结论:自体PRP凝胶联合VSD技术修复难愈性创面，抑菌效果好，可提高创面愈合率，缩短创面愈合时间，减轻疼痛和瘢痕增生程度，且无不良反应，值得推广。“,”Objective:To investigate the clinical effects of autologous platelet rich plasma gel (PRP) combined with vacuum sealing drainage (VSD) technology on the repair of refractory wounds.Methods:From March 2011 to January 2015, 44 patients with refractory wounds and conformed to the inclusion criteria were included into VSD alone group, who were admitted to the Department of Burn and Plastic Surgery of the Yidu Central Hospital of Weifang and received intermittent VSD treatment. From February 2015 to September 2019, 43 patients with refractory wounds and conformed to the inclusion criteria were included into PRP+VSD group, who were admitted to the same unit above-mentioned and received PRP combined with intermittent VSD treatment.The retrospective cohort study was conducted. There were 24 males and 20 females with ages of (37.5±2.2) years in VSD alone group, and there were 25 males and 18 females with ages of (37.0±2.5) years in PRP+VSD group. The wound secretions of patients in the two groups before and 7, 14 d after the first treatment were collected for bacterial culture, and the positive rate of bacterial culture was calculated.The wound healing of patients in the two groups was observed on 7, 14,and 21 d after the first treatment, and the wound healing rate was calculated. The complete wound healing time of patients in the two groups was recorded. The degree of wound pain of patients in the two groups was evaluated by the visual analog scale (VAS) before and 14 d after the first treatment. The scar hyperplasia of patients in the two groups was evaluated by the Vancouver Scar Scale (VSS) in 1 and 2 months after the wound healed completely.The incidence of adverse reactions of patients in the two groups after the treatment was observed and the incidence of adverse reactions was calculated.Data were statistically analyzed with analysis of variance for repeated measurement, chi-square test, paired t test, and Bonferroni correction.Results:The positive rates of bacterial culture of patients in PRP+VSD on 7 and 14 d after the first treatment were 37.2% (16/43) and 11.6% (5/43), which were significantly lower than 56.8% (25/44) and 29.5% (13/44) in VSD alone group, n χ2= 4.212, 4.255, n P<0.05. The wound healing rates of patients in PRP+VSD group on 7, 14 and 21 d after the first treatment were (58±14)%, (70±13)%, (89±12)%, which were significantly higher than (41±11)%, (60±11)%, (74±12)% in VSD alone group,n t=6.323, 3.820, 5.751, n P<0.01. The complete wound healing time of patients in PRP+VSD group was (30±6) d, which was significantly shorter than (61±8) d in VSD alone group,n t=20.89, n P<0.05. The VAS score of patients in PRP+VSD group was significantly lower than that in VSD alone group (t=13.904,n P<0.01). The VSS score of patients in PRP+VSD group was significantly lower than that in VSD alone group in 1 and 2 months after the wound healed completely (t=3.307, 3.637,n P<0.01). The incidence of adverse reactions of patients in PRP+VSD group after the treatment was 7.0% (3/43),which was significantly lower than 22.7% (10/44) in VSD alone group alone,n χ2=4.245, n P<0.05.n Conclusions:Autologous PRP gel combined with VSD technology to repair refractory wounds not only has good bacteriostatic effect, but also can increase wound healing rate, shorten wound healing time, reduce wound pain, relieve scar hyperplasia, and without adverse reactions, which is worthy of promotion.