Clinical and Microbiological Outcomes Associated With Use of Platelet-Rich Plasma in Chronic Venous Leg Uclers

Abstract

PURPOSE:To evaluate the susceptibility profi les of Staphylococcus aureus and Pseudomonas aeruginosa strains identifi ed in chronic venous ulcers treated with platelet-rich plasma (PRP) and petrolatum gauze or petrolatum gauze alone and to quantitatively evaluate the bacterial load and biofi lm-forming capacities of the detected S. aureus and P. aeruginosa strains. DESIGN: Randomized controlled trial. SUBJECTS AND SETTING:The convenience sample included 36 participants; 18 were allocated to the PRP combined with the petrolatum gauze group, and 18 were allocated to the control group, which was treated with petrolatum gauze alone. METHODS: Thirty-six patients presenting with chronic venous ulcers were consecutively randomized to the PRP group (n = 18) or the petrolatum gauze control group (n = 18). We followed participants for 3 months during treatment and collected swab cultures from their wounds during weeks 1, 6, and 12 or until the wounds healed. The samples were analyzed using mass spectrometry. Antimicrobial susceptibility tests were performed using disk diffusion. RESULTS: P. aeruginosa was identifi ed in 39 (39%) of 100 samples, and S. aureus was detected in only 10 (10%) samples collected over the study period. At the end of the 12-week treatment period, the wound infections reduced in both the PRP ( P = .0078) and control groups ( P = .01). The microorganisms were susceptible to most of the tested antimicrobials. The PRP did not increase the bacterial load in the wounds. All S. aureus strains identifi ed showed biofi lm-forming capacities and were classifi ed as weak biofi lm producers. All P. aeruginosa strains produced biofi lm, with 17 strains being classifi ed as weak, 14 as moderate, and 8 as strong biofi lm producers. CONCLUSIONS:The PRP plus petrolatum gauze did not increase bacteriological growth or the microbial load in chronic venous ulcers compared with petrolatum gauze alone and could be a considered as an advanced treatment option for these types of chronic wounds.

The Rationale for Platelet-Rich Plasma (Prp) Therapy in Chronic Wounds : Systematic Review

“…Pires, et al (2021) 13 At the conclusion of the 12-week treatment period, both the PRP (P = 0.0078) and control groups (P = 0.01) experienced a reduction in wound infections. The microorganisms were susceptible to the vast majority of antimicrobials tested.…”

Efficacy and safety of platelet‐rich plasma in the treatment of venous ulcers: A systematic review and meta‐analysis of randomized controlled trials

“…Seven studies assessed the rate of infection, 21,25,26,31,32,35 finding no significant difference between the two groups (OR = 0.89, 95% CI: 0.38–2.07, I 2 = 0%; Figure 8).…”

“…Ultimately, 16 RCTs were included in the meta-analysis (Figure 1). [18][19][20][21][25][26][27][28][29][30][31][32][33][34][35][36]…”

“…Out of the 19 studies that reported on complete ulcer closure, one was excluded due to the absence of control group data. 36 Based on the remaining 18 studies, [18][19][20][21]25,26,[28][29][30][31][32][33][34][35] the weighted OR for complete closure was 5.06 (95% CI: 2.35-10.89, I 2 = 58%, p < 0.01), in favour of the PRP group (Figure 3).…”

The Efficiency and Safety of Platelet-Rich Plasma Dressing in the Treatment of Chronic Wounds: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…In addition, some researchers found that chronic wounds in the PRP group showed bright red granulation after 4 weeks of treatment, which was helpful to reduce inflammation exudation [ 61 ]. Pires et al [ 62 ] found that there was a similar amount of bacteriological growth in the excretion culturing of the PRP and normal saline dressing groups. These results confirmed the mechanisms of PRP, i.e., that growth factors from PRP could reduce local inflammation and promote angiogenesis and tissue regeneration around the wound.…”