Intralesional autologous platelet rich plasma therapy in chronic nonhealing cutaneous ulcers: an interventional study from a tertiary care centre in North Kerala

Abstract

<p class="abstract"><strong>Background:</strong> Treatment of chronic nonhealing cutaneous ulcers is a challenge to clinicians. When wounds fail to achieve sufficient healing after 4 weeks of conventional therapy reassess the underlying pathology and consider advanced therapeutic options. Autologous platelet rich plasma is a novel treatment for nonhealing cutaneous ulcers, which can provide growth factors directly onto the wound.</p><p class="abstract"><strong>Methods:</strong> 34 patients with non-healing cutaneous ulcers satisfying inclusion and exclusion criteria were included in the study. All patients were treated with PRP therapy weekly for 6 weeks. Every week ulcer area and volume was measured and outcome expressed as improvement in area and volume of ulcers before and after PRP therapy.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study majority were males (64%) and the mean age of population was 51.0±10.4 years. Of 34 patients 18 had venous ulcers. All ulcers healed within 12 weeks and mean duration of healing was 7.51±2.9 weeks. 8 (24.24%) patients had their ulcer completely healed within 6 weeks. Larger ulcers took long duration to heal and smaller ones healed within short duration. The total improvement in area and volume of ulcers was 85.7% and 90.7% (median) respectively at the end of 6 weeks.</p><p class="abstract"><strong>Conclusions:</strong> PRP is an effective, safe, readily available and cheap outpatient procedure which can be widely used for the treatment of chronic recalcitrant ulcers which improves the quality of life and reduces the financial burden of patients. Further research and controlled, randomized prospective clinical trials on larger population are necessary to validate the results.</p>

Efficacy and Safety of Intralesional Platelet Rich Plasma (PRP) Therapy in the Management of Chronic Non-healing Leg Ulcers in our Population

“…Frykberg et al 11 carried out a study on 49 patient with 65 non healing venous leg ulcers; the mean percentage reduction of volume and area were 56.1% and 43.1% respectively, with a mean treatment duration of 2.3 week. In our study, the mean percentage reduction of the volume and area was calculated to be 86% and 88%, with a mean of 5.3 week treatment, while in a study conducted by Gopinath et al 8 on 33 patient, the total improvement in the volume and area of ulcers were noted to be 90.7% and 85.7% respectively at the end of 6 th week. In a study by Suryanarayanan et al 12 patients having 33 ulcer were treated for 6 weeks; percentage improvement in volume and area were 95% and 91.7% respectively and is comparable with our study.…”

“…It can be applied either directly on to the floor of the ulcer as gel form or by sprinkling onto the wound surface and can also be given as intralesional injection on to the margins and floor of the ulcer/wound. 8 In our study on 26 patients with 30 chronic nonhealing leg ulcers, the mean time period for healing of ulcer/wounds were 5.3 weeks, while in a study by Gopinath et al 8 on 33 patient, mean duration of healing was 7.67±2.314 weeks. Another study by Bernuzzi et al 9 the mean duration of healing was 6.2 weeks.…”

Efficacy of platelet rich plasma in chronic leg ulcers: a prospective randomized controlled study

“…15 Considering that there is a lack of a well-defined standard method of preparing PRP, we chose the double spin method so as to adequately concentrate the platelets in the plasma as done by other studies. 16 We conducted a randomized control study to assess the efficacy of PRP to conventional moist dressing in the treatment of chronic leg ulcers. The two groups were well matched in respect to the age of the patients and sex distribution.…”

Intralesional agents in dermatology: Pros and cons

“…Treatment details of platelet-rich plasma (PRP) in various dermatological conditions are enlisted in Table 3 . [ 29 30 31 32 33 34 35 36 ] PRP was prepared using a double centrifugation technique. PRP is a safe, simple, inexpensive, and biocompatible procedure.…”