Autologous platelet‐rich gel treatment for diabetic chronic cutaneous ulcers: A meta‐analysis of randomized controlled trials

Li, Yan; Gao, Yunyi; Gao, Yun; Chen, Fan; Wang, Chun; Liu, Guanjian; Yang, Xiao; Ran, Xingwu

doi:10.1111/1753-0407.12850

Cited by 19 publications

(20 citation statements)

References 33 publications

(88 reference statements)

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“…conducted a meta-analysis of 15 RCTs (a total of 829 people) involving the use of PRPG for the treatment of diabetic chronic skin ulcers and compared the results with those from standard medical care. They found a significantly increased healing rate of ulcers (RR = 1.39; 95% CI, 1.29–1.50; p < 0.00001), a shortened healing time (Mean difference = −9.18; 95% CI, −11.3−7.05; p < 0.00001) and a reduced incidence of infection (RR = 0.34; 95% CI, 0.15-0.77; p = 0.009) [ 135 ]. In summary, to date, the level of evidence for all growth factor (GF) treatment studies is only low-to-moderate, and this article makes a weak recommendation for their use in diabetic foot.…”

Section: Management Of Diabetic Footmentioning

confidence: 99%

Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition)

Wang¹,

Cheng

et al. 2020

Burns &Amp; Trauma

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Abstract In recent years, as living standards have continued to improve, the number of diabetes patients in China, along with the incidence of complications associated with the disease, has been increasing. Among these complications, diabetic foot disease is one of the main causes of disability and death in diabetic patients. Due to the differences in economy, culture, religion and level of medical care available across different regions, preventive and treatment methods and curative results for diabetic foot vary greatly. In multidisciplinary models built around diabetic foot, the timely assessment and diagnosis of wounds and appropriate methods of prevention and treatment with internal and external surgery are key to clinical practice for this pathology. In 2019, under the leadership of the Jiangsu Medical Association and Chinese Diabetes Society, the writing group for the Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition) was established with the participation of scholars from the specialist areas of endocrinology, burn injury, vascular surgery, orthopedics, foot and ankle surgery and cardiology. Drawing lessons from diabetic foot guidelines from other countries, this guide analyses clinical practices for diabetic foot, queries the theoretical basis and grades and gives recommendations based on the characteristics of the pathology in China. This paper begins with assessments and diagnoses of diabetic foot, then describes treatments for diabetic foot in detail, and ends with protections for high-risk feet and the prevention of ulcers. This manuscript covers the disciplines of internal medicine, surgical, nursing and rehabilitation and describes a total of 50 recommendations that we hope will provide procedures and protocols for clinicians dealing with diabetic foot.

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Section: Management Of Diabetic Footmentioning

confidence: 99%

Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition)

Wang¹,

Cheng

et al. 2020

Burns &Amp; Trauma

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“…Platelets for PG come from patients' own blood, 5,8,54,55,57,60,65,68,71,76 donors' blood, 56,58,[61][62][63]67,69,72 and cord blood. 59,[73][74][75] Advantages of APG are no need for blood type matching, without risk of transfusionrelated infections, and easy to collect blood.…”

Section: Source Of Platelet For Pgmentioning

confidence: 99%

Current applications of platelet gels in wound healing—A review

Wang

Yang

Zhao

et al. 2021

Wound Repair Regeneration

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Human platelets play important roles in several physiologic and pathologic processes.Platelet concentrates are activated with thrombin or calcium, resulting in a viscous coagulum (platelet gel [PG]), composed of 95% platelets at least. PG is increasingly used for the treatment of a variety of soft and hard tissue defects, most notably in the management of chronic non-healing wounds. During wound healing, platelets not only play a critical role in primary hemostasis and thrombosis, but also release growth factors and cytokines to promote tissue regeneration, enhance collagen synthesis, and trigger an immune response. This review addresses a variety of aspects relevant to the functions of well-known platelet growth factors, animal and clinical studies of PG in the last decade, and different sources of platelets for PG. PG is used for nonhealing chronic wounds, such as oral ulcerations related to epidermolysis bullosa and chronic graft-versus-host disease, for those, the traditional treatment effect is poor.PG maybe provide a new therapeutic direction for these diseases. Nevertheless, some uncertainty is present, the number of clinical studies is not enough. Hence, randomized controlled trials are still required to study the potential of the use of PG in the near future. K E Y W O R D Splatelet gel, platelet growth factor, platelet-rich plasma, wound healing | INTRODUCTIONOver the past three decades, extensive cellular and molecular details were elucidated regarding the regulation of cutaneous wound healing. 1,2 Although platelets are fundamental components of the hemostatic response to vessel damage. It is worth noting that platelet rich plasma (PRP) gel/platelet gel (PG) is increasingly used for the treatment of a variety of soft and hard tissue defects, most notably in the management of chronic non-healing wounds and in accelerating bone formation. [3][4][5][6][7][8] Wound healing is a very intricate process involving the complex interplay of numerous humoral factors and cells. PG as a new application was proposed during the last 30 years, to favour wound healing through the growth factors (GFs) released by platelets during clotting. Platelet concentrates are activated with thrombin or calcium, which induces the release of GFs and also fibrin generation, resulting in a viscous coagulum (PG), composed of 95% platelets at least. 9 A wound is defined as damage or disruption to the normal anatomical structure and function, and it may cause damage in other structures such as tendons, muscles, vessels, nerves, parenchymal

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“…Hence, solving persistent inflammation, impaired cell proliferation and migration, decreased angiogenesis, and remodeling of the extracellular matrix (ECM) is important. Innovative wound repair methods, such as local negative pressure, growth factors, and autologous platelet-rich gels, have remarkable effects on healing DCWs[ 12 - 15 ]. However, more specific treatment options are required for refractory and contraindicated wounds.…”

Section: Introductionmentioning

confidence: 99%

Mesenchymal stem cell-derived exosomes: The dawn of diabetic wound healing

Wu¹,

Sun²,

Li³

et al. 2022

World J Diabetes

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Chronic wound healing has long been an unmet medical need in the field of wound repair, with diabetes being one of the major etiologies. Diabetic chronic wounds (DCWs), especially diabetic foot ulcers, are one of the most threatening chronic complications of diabetes. Although the treatment strategies, drugs, and dressings for DCWs have made great progress, they remain ineffective in some patients with refractory wounds. Stem cell-based therapies have achieved specific efficacy in various fields, with mesenchymal stem cells (MSCs) being the most widely used. Although MSCs have achieved good feedback in preclinical studies and clinical trials in the treatment of cutaneous wounds or other situations, the potential safety concerns associated with allogeneic/autologous stem cells and unknown long-term health effects need further attention and supervision. Recent studies have reported that stem cells mainly exert their trauma repair effects through paracrine secretion, and exosomes play an important role in intercellular communication as their main bioactive component. MSC-derived exosomes (MSC-Exos) inherit the powerful inflammation and immune modulation, angiogenesis, cell proliferation and migration promotion, oxidative stress alleviation, collagen remodeling imbalances regulation of their parental cells, and can avoid the potential risks of direct stem cell transplantation to a large extent, thus demonstrating promising performance as novel "cell-free" therapies in chronic wounds. This review aimed to elucidate the potential mechanism and update the progress of MSC-Exos in DCW healing, thereby providing new therapeutic directions for DCWs that are difficult to be cured using conventional therapy.

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Autologous platelet‐rich gel treatment for diabetic chronic cutaneous ulcers: A meta‐analysis of randomized controlled trials

Abstract: Current evidence suggests that APG is effective and safe, and is feasible for use as an adjuvant treatment for diabetic ulcers, especially chronic refractory ulcers. However, more RCTs with a good design and of a high quality are needed before the use of APG can be implemented widely.

Cited by 19 publications

References 33 publications

Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition)

Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition)

Current applications of platelet gels in wound healing—A review

Mesenchymal stem cell-derived exosomes: The dawn of diabetic wound healing

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