Intralesional autologous platelet rich plasma therapy in chronic nonhealing cutaneous ulcers: an interventional study from a tertiary care centre in North Kerala (original) (raw)
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Management of Chronic Non-Healing Ulcers by Topical Application of Platelet Rich Plasma (PRP)
International Journal of Scientific Research in Science and Technology, 2022
Disturbance of the normal anatomic structure and functional integrity of the skin can be described as wound. Chronic or non-healing ulcers are defined as ulcers which are failed to heal in less than 3 weeks of duration .If normal healing process is interrupted ulcer can become chronic in nature due to lack of growth factors and cytokines which is results in delay of wound healing. Conventional treatment for chronic non-healing ulcers includes wound cleansing and necrotic tissue debridement. The use of patient’s own body cells for ulcer treatment relies upon the components present in the blood and platelet concentrate, which contains various cytokines and growth factors. Autologous PRP is a platelet suspension in plasma derived from whole blood that is increasingly being used in clinical practice for the treatment of chronic non healing ulcers. OBJECTIVE: To assess the efficacy of topical application of autologous platelet rich plasma in wound healings. METHODOLOGY: The study was conducted in the department of General Surgery, GREAT EASTERN MEDICAL SCIENCES during the period of February 2021 to February 2022 . Ten patients between 18-80 yrs ,of any sex, with chronic non-healing ulcers of different etiologies were treated with topical application of PRP. RESULTS : Ten patients each having ulcer of varying etiology were included .Treated with Topical administration of AUTOLOGOUS PRP solution over the ulcer. Among the included patients 6(60%) were males and 4 (40%) were females with a mean age of 62.5± 13.53 years. Out of 10 patients 4(40%) were in 61-80 years age group,2(20%)were in 41-60 years age group and 4(40%) patients was less than 40 years .The duration of the chronic non healing ulcers presented by the patients range from 9 to 24 weeks with a mean duration of 16weeks.After application of PRP solution ,the mean healing time was found to be almost 8.2 weeks±1.9weeks.After the application of PRP solution small islands of granulating tissue appeared over the wound and a significant reduction in ulcer size was observed as a sign of healing and improvement. CONCLUSION: In our study, the results showed that PRP is a safe and effective treatment modality for chronic non-healing ulcers. Delivering of growth factors to target site enhances the wound healing rates of chronic non healing ulcers.PRP seems to be efficient to treat chronic non healing ulcers which are non responsive to classical conservative treatments. Using PRP to treat chronic wounds/ulcers may not only enhance healing, but also prevent lower extremity amputations caused by nonhealing wounds.There by reducing over all hospital stay, inconvenience of constant medication and morbidity.
Introduction: Chronic non healing ulcers due to diseases like Hansen's, venous insufficiency, diabetes etc. are the major causes for disability. It has been shown that autologous platelet rich plasma (PRP) is effective in healing chronic non healing ulcers. Aim: The objective of this study is to demonstrate the efficacy of autologous platelet rich plasma in patients with chronic non healing ulcers. Study design: Institution based prospective study Participants: Sixteen patients with chronic non healing ulcers of different etiology were taken with a mean age of 48.7years with 24 non healing ulcers of more than 6 weeks. Measurements: photographs were taken before treatment and at every subsequent sitting. Area and volume were calculated at baseline and at every subsequent sitting till the closure was achieved. Materials and methods: Ulcers were treated prior with antibiotics and then those healthy ulcers were treated with PRP injections at weekly intervals, repeated once a week for a minimum of five weeks and extended in case of larger ulcers like those associated with cellulitis as per requirement. Results: The mean percentage of improvement in the area was 65.4 % and volume was 70.2% at the end of second sitting. All ulcers almost closed at the end of five sittings. No adverse events were noted. Conclusion: Autologous PRP for the treatment of chronic non healing ulcers is a feasible, simple, safe and inexpensive method. The growth factors present in autologous PRP helps in a better and faster healing of the ulcers.This method of treatment is a huge step forward in preservation of resources and prevention of morbidity.
Study of efficacy of autologous Platelet Rich Plasma in enhancing the healing of acute ulcers
Background: Autologous Platelet Rich Plasma (PRP) is a modern modality for healing of wounds. But there is paucity in the studies demonstrating the efficacy of PRP with no consensus about its efficacy in healing as compared to conventional methods. As healing of acute ulcers is mainly dependent on local therapy, we performed to this study to study the efficacy of PRP in healing of acute ulcers Aims and objectives: Aim of the study is to study the efficacy of PRP in healing of acute ulcers. Objectives: to assess the healing rate, to assess the time taken for complete healing/ ulcer eligible for grafting and to note complications or adverse effects during the study. Materials and methods: a single arm prospective clinical study which included patients 18-80 years with acute ulcers of maximum area 10 x 10 cm 2. Venous ulcers, diabetic ulcers, pressure sores, burn wounds, arterial ulcers were excluded. Ulcer characteristics like dimensions, area, slough, discharge, edge along with clinical photograph were noted during the start of the study. Ulcers underwent weekly PRP dressings after preparation of autologous PRP and ulcer characteristics were noted at the time of dressing along with pain score and clinical photograph. The end point of study was completely healed ulcer/ ulcer fit for skin grafting. Results: 28 ulcers were included. 23 healed by re-epithelisation while 5 healed by grafting. The healing rate calculated as percentage reduction in area/ week had significant increase over the weeks (p< 0.0001). No difference was noted in the healing rates of ulcers with diabetes and ulcers without diabetes (p=0.45). The mean duration of healing was 5.1 ± 1.85 weeks for complete re-epithelisation while it was 3 weeks for ulcers eligible for skin grafting. Only 3 ulcers (11%) had persistent slough after 1 st PRP application. No complications of wound infection or adverse effects were noted. Pain score had a decreasing trend over the weeks. Conclusions: PRP is an efficacious treatment modality for treatment of acute ulcers which is cheap, affordable and easily available. Due to reduced dressing frequency and pain, it positively impact quality of life of patients. It is not associated with any adverse effects or complication of wound infection and can be easily combined with traditional methods of wound healing to augment the process of healing.
Platelet rich plasma in treatment of chronic non healing ulcers: a study of ten cases
International Journal of Research in Dermatology
Background: Platelet rich plasma (PRP) helps tissue re-modulation by its growth factors (GFs)– platelet derived growth factor (PDGF), transforming growth factor (TGF-β), epidermal growth factor (EGF), fibroblast growth factor (FGF-2), insulin-like growth factor (IGF). These GFs aid healing by attracting undifferentiated stem cells into newly formed matrix and triggering cell division; by promoting capillary growth and by attracting macrophages to improve tissue healing and regeneration. The aims and objectives of the study were to assess reduction in wound size of chronic non-healing ulcers by autologous platelet rich plasma and to evaluate the safety of autologous platelet rich plasma in treatment of chronic non healing ulcers.Methods: This was an experimental study conducted on ten patients of chronic non-healing ulcers of varied etiology. Autologous PRP was freshly prepared using 10 ml of patient’s own blood by differential centrifugation process and injected at the margins and b...
Chronic Wounds Are A Major Health Challenge And Are A Growing Socioeconomic Problem All Over The World. The Goal Of Wound Care In Chronic Ulcers Is To Facilitate Healing Using Standardized Protocols Of Wound Care. The Main Goal Of Any Treatment Modality Is To Obtain Wound Closure Expeditiously. The Aim Of Our Study Is To Compare And Find Out Which Is Better Among Platelet-Rich Plasma Vs. Conventional Dressing. In This Study, A Total Of 50 Patients Of Chronic Non Healing Ulcers Who Presented In Our Institute Were Evaluated From December 2015 To October 2017.Patients Were Randomly Grouped Into Two Groups-PRP And Conventional Dressing Group Of 25 Patients Each. Definitely, PRP Group Showed Better Results In Term Of Healing Rate And Required Significantly Less Number Of Dressings For Wound Closure. Results From Our Research Showed That PRP Is A Safe And Effective Treatment Modality For Chronic Non-Healing Ulcers. Using PRP To Treat Chronic Wounds/Ulcers May Not Only Enhance Healing But Also Prevent Lower Extremity Amputations Caused By Non-Healing Wounds.
Treatment of chronic non-healing ulcers using autologous platelet rich plasma: a case series
Journal of Biomedical Science, 2017
Background: Non-healing ulcers are a major health problem worldwide and have great impact at personal, professional and social levels, with high cost in terms of human and material resources. Recalcitrant non-healing ulcers are inevitable and detrimental to the lower limb and are a major cause of non-traumatic lower limb amputations. Application of autologous Platelet Rich Plasma (PRP) has been a major breakthrough for the treatment of non-healing and diabetic foot ulcers, as it is an easy and cost-effective method, and provides the necessary growth factors that enhance tissue healing. PRP is a conglomeration of thrombocytes, cytokines and various growth factors which are secreted by α-granules of platelets that augment the rate of natural healing process with decrease in time. The purpose of this case series was to evaluate the safety and efficacy of autologous platelet rich plasma for the treatment of chronic non-healing ulcers on the lower extremity. Methods: Autologous PRP was prepared from whole blood utilizing a rapid, intraoperative point-of-care system that works on the principle of density gradient centrifugation. Twenty Four (24) patients with non-healing ulcers of different etiologies, who met the inclusion criteria, were treated with single dose of subcutaneous PRP injections along with topical application of PRP gel under compassionate use. Results: The mean age of the treated patients was 62.5 ± 13.53 years and they were followed-up for a period of 24 weeks. All the patients showed signs of wound healing with reduction in wound size, and the mean time duration to ulcer healing was 8.2 weeks. Also, an average five fold increase in the platelet concentrate was observed in the final PRP product obtained using the rapid point-of-care device, and the average platelet dose administered to the patients was 70.10 × 10 8. Conclusion: This case series has demonstrated the potential safety and efficacy of autologous platelet rich plasma for the treatment of chronic non-healing ulcers.
A clinical study on efficacy of peri-lesional autologous platelet-rich plasma in non-healing ulcers
International Surgery Journal
Background: Non-healing ulcers are a major health problem worldwide and have a great impact at personal, professional, and social levels. They are a major cause of non-traumatic lower limb amputations. The application of autologous Platelet Rich Plasma (PRP) has been a breakthrough in the treatment of non-healing ulcers, as it is an easy and cost-effective procedure, and provides the necessary growth factors that enhance tissue healing. The aim and objective of the study was to test the effectiveness of peri-ulcer autologous platelet-rich plasma injection in chronic non-healing ulcers and to assess the time taken for wound closure.Methods: This study was conducted on 50 patients during the period of November 2020 to October 2021 from the in-patients of the surgical unit in Dr. PSIMS and RF. Autologous PRP was prepared from whole blood utilizing a rapid, point-of-care system that works on the principle of density gradient centrifugation. Fifty (50) patients with non-healing ulcers of...
Role of platelet rich plasma in chronic non- healing ulcer: An observational study
International Journal of Surgery Science, 2021
Diabetic foot ulcer is a major complication of diabetes mellitus. Patients with poorly controlled diabetes, can develop ulcer around their feet for which amputation is the last resort and risk of re-amputation is high. Over the recent years, great progress has been made in the techniques of wound healing, among which autologous platelet-rich plasma (PRP) has attracted the most substantial attention. This was a prospectively designed study that evaluated the effect of PRP in patients with different types of ulcers. 70 patients with 82 non healing ulcers of various etiologies were treated with PRP at weekly intervals. The mean age of the patients was 42.5 years. the mean duration of ulcers was 4.75 months. About 100% improvement in the area was seen in 25 of the ulcers and 100% improvement in volume was seen in 24 of the ulcers at the end of the treatment. There was reduction in pain and discharge within 1 week. There were no side effects noted.
Polish Journal of Surgery, 2015
Wound healing is a complex pathophysiological process, in which platelets play a crucial role. Platelet alpha-granules release growth factors to the wound bed; the factors are necessary in the healing process. In chronic wounds, such as poorly healing lower-leg ulcers of venous origin, there is decreased activity of multiple growth factors, so the concept of exogenous delivery of such factors seems a logical strategy. Platelet-rich plasma therapy in patients with lower-leg ulcers of venous origin combined with conventional treatment methods (previously ineffective in these patients) seems, based on our observation, an important adjunct leading to recovery.The aim of the study was to present an original method of autologous platelet-rich plasma application through the creation of a sort of “biological chamber” containing a concentrate of growth factors.Material and methods. The described therapy was implemented in 10 patients, who had been ineffectively treated for more than one year...
Autologous Platelet-Rich Plasma for Nonhealing Ulcers: A Comparative Study
Vascular Specialist International, 2019
The use of platelet-rich plasma (PRP) for the treatment of nonhealing ulcers is a relatively new technique. Although it seems to result in a satisfying level of healing and low complication rates, data regarding its effectiveness remain sparse. This study aims to evaluate the potential therapeutic effects of PRP on chronic nonhealing ulcers. Materials and Methods: This was a prospectively designed study comparing outcomes between patients treated with PRP (Group A, n=15) and patients treated conventionally (Group B, n=12) for different types of nonhealing ulcers. In Group A, PRP was produced from the patients' own peripheral blood samples and was applied on the ulcer once every week. In Group B, patients were treated conventionally, without applying PRP. The total treatment period was 5 weeks. Results: Both groups were similar regarding age, sex, comorbidities, and time of treatment. In Group A, patients showed a nonsignificant reduction of 4.5 mm 2 in ulcer area (P=0.190) and a reduction of more than 1 mm in depth (P=0.0006), while Group B showed an increase of 108±80.5 mm 2 in ulcer area after 5 weeks (P=0.016). The healing rate (HR) in Group A was stable and positive throughout the treatment period, while HR in Group B was initially negative but became positive after the 3rd week. Conclusion: PRP application once a week promotes the healing of chronic ulcers. It improves the ulcer's depth and HR, although its effect on ulcer area seems to be nonsignificant. However, larger comparative series are still needed to confirm these findings.