scholarly journals Treatment of Nonhealing Diabetic Lower Extremity Ulcers with Skin Graft and Autologous Platelet Gel: A Case Series

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Yuan-Sheng Tzeng ◽  
Shou-Cheng Deng ◽  
Chih-Hsing Wang ◽  
Jui-Che Tsai ◽  
Tim-Mo Chen ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Skin Graft ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Split Thickness Skin Graft ◽  
Diabetic Patients ◽  
Ulcer Recurrence ◽  
Platelet Gel ◽  
Large Size ◽  
Autologous Platelet

Lower extremity ulcers in diabetic patients are difficult to treat. Recently, the use of human blood platelet-derived components in this indication has been raising interest. In this study, we have evaluated the safety and efficacy of the combination of autologous platelet gel (PG) and skin graft for treating large size recalcitrant ulcers. Eight consecutive diabetic patients aged 25 to 82 with nine nonhealing lower extremity ulcers (median size of 50 cm2; range 15–150 cm2) were treated. Skin ulcer was debrided, and the wound was sprayed after 7 to 10 days with autologous platelet-rich plasma and thrombin. Thin split-thickness skin graft with multiple slits was then applied on the wound bed and fixed with staples or cat-gut sutures. There were no adverse reactions observed during the study. Eight out of 9 skin grafts took well. The interval between skin graft and complete wound healing ranged from 2 to 3 weeks in the 8 successful cases. No ulcer recurrence was noted in those patients during the follow-up period of 2 to 19 months. In this study, the combination of autologous platelet gel and skin grafting has proven beneficial to heal large-size recalcitrant ulcers.

scholarly journals Efficacy of autologous platelet rich plasma over conventional mechanical fixation methods in split thickness skin grafting

2018 ◽  
Vol 6 (1) ◽  
pp. 108 ◽  
Author(s):  
Girish Umashankar Thimmanahalli ◽  
Mahesh Kumar
Keyword(s):  
Skin Graft ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Split Thickness Skin Graft ◽  
Skin Defect ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Autologous Platelet Rich Plasma ◽  
Graft Reconstruction ◽  
Autologous Platelet

Background: Platelet-Rich Plasma (PRP) is an autologous product derived from whole blood through the process of gradient density centrifugation. After skin graft reconstruction, the healing process is longer and may be difficult, depending on the wound site, skin defect size, and patient comorbidities. The potential value of PRP lies in its ability to incorporate high concentrations of platelet-derived growth factors into the skin graft. Since not all patients afford commercially available recombinant platelet rich plasma for skin graft, platelet extract from patient’s own blood is being used in this study to test and demonstrate the therapeutic role of PRP in skin graft. The aim of this randomized, prospective study is to compare the effectiveness of PRP in skin graft with conventional method like sutures, staplers or glue.Methods: The source of data were the patients admitted as inpatients for the management of wounds to the department of general surgery, JSS Hospital, Mysore from September 2016 to September 2018. Total of 60 patients were studied; 30 cases were randomly chosen for study with autologous platelet rich plasma and 30 cases received conventional methods like staples/sutures used to anchor the skin grafts in a control group.Results: Autologous PRP showed faster and better healing rates. With PRP study group instant graft adherence was seen in all cases. Hematoma, graft edema, discharge from graft site, frequency of dressings and duration of stay in hospital were significantly less in the PRP. There were no adverse effects or reactions seen with the use of autologous PRP among the study group.Conclusions: The combination of PRP with Split Thickness Skin Graft (STSG) significantly improved clinical outcomes and shortened the wound healing time. Therefore, this treatment combination could provide a way to heal skin after skin graft reconstruction with minimal recovery time. It is found to be highly beneficial in many aspects both to the patient and surgeon based on our results.

Effects of low level laser therapy on the prognosis of split-thickness skin graft in type 3 burn of diabetic patients: a case series

2016 ◽  
Vol 31 (3) ◽  
pp. 497-502 ◽  
Author(s):  
Mostafa Dahmardehei ◽  
Nooshafarin Kazemikhoo ◽  
Reza Vaghardoost ◽  
Soheila Mokmeli ◽  
Mahnoush Momeni ◽  
...  
Keyword(s):  
Laser Therapy ◽  
Skin Graft ◽  
Case Series ◽  
Low Level Laser Therapy ◽  
Split Thickness Skin Graft ◽  
Diabetic Patients ◽  
Low Level Laser ◽  
Thickness Skin ◽  
Level Laser ◽  
Type 3

scholarly journals Successful Management of Treatment-Resistant Alopecia Areata with Platelet Rich Plasma: A Case Series

2019 ◽  
Vol 11 (2) ◽  
pp. 50-52
Author(s):  
Sanjeewani Fonseka ◽  
Y.M.D.M Bandara ◽  
Brabaharan Subhani
Keyword(s):  
Alopecia Areata ◽  
Platelet Rich Plasma ◽  
Case Reports ◽  
Immunosuppressive Agents ◽  
Case Series ◽  
Treatment Resistant ◽  
Successful Management ◽  
Autologous Platelet Rich Plasma ◽  
Dermal Injection ◽  
Autologous Platelet

Abstract Introduction. Alopecia areata (AA) is an autoimmune disease-causing non-scarring alopecia. It is usually treated with immunosuppressive agents, to which some patients fail to respond adequately. Material and Methods. Three patients with AA refractory to standard therapy were treated with intra-dermal injection of autologous platelet rich plasma (PRP) every four weeks. Results. All three patients showed remarkable improvement after multiple sessions of PRP treatment. Conclusion. Autologous PRP is safe and effective in treatment-resistant forms of AA demonstrated in many case reports; therefore it deserves further study with randomized, placebo-controlled trials.

scholarly journals Comparison of Allogeneic Platelet-rich Plasma With Autologous Platelet-rich Plasma for the Treatment of Diabetic Lower Extremity Ulcers

2020 ◽  
Vol 29 ◽  
pp. 096368972093142
Author(s):  
Min He ◽  
Xuewen Guo ◽  
Tao Li ◽  
Xiaoyan Jiang ◽  
Yan Chen ◽  
...  
Keyword(s):  
Wound Healing ◽  
Lower Extremity ◽  
Adverse Reactions ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Ankle Brachial Index ◽  
Nutritional Regulation ◽  
Significant Difference ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Autologous platelet-rich plasma (au-PRP) has been widely used for the management of refractory chronic wounds. However, patients with diabetic lower extremity ulcers (DLEUs) usually have complicated clinical conditions, and the utility of au-PRP is limited. In this study, the feasibility, effectiveness, and safety of allogeneic platelet-rich plasma (al-PRP) and au-PRP were investigated and compared in the treatment of DLEUs. A total of 75 in-patients with type 2 diabetes were assigned to the al-PRP group ( n = 20), au-PRP group ( n = 25), and conventional wound therapeutic (CWT) group ( n = 30) matched by the ankle brachial index and ulcer size from December 2015 to August 2018. Based on metabolic and nutritional regulation, infective control, and topical wound management, al-PRP, au-PRP, and CWT were administered to each group, respectively. Evaluation of treatment outcomes was determined by the parameters of wound healing and adverse reactions. The therapeutic times and average concentration of platelets were not significantly different between the au-PRP and al-PRP groups. The wound healing times of the al-PRP group (56.9 ± 29.22 d) and au-PRP group (55.6 ± 33.8 d) were significantly shorter than those of the CWT group (88.0 ± 43.4 d) ( P < 0.01), but there was no significant difference between the groups with PRP treatment. Although there was no significant difference in the daily healing area among all groups ( P > 0.05), the trend of the healing rate in the al-PRP group (16.77 ± 12.85 mm2), au-PRP group (14.31 ± 18.28 mm2), and CWT group (9.90 ± 8.51 mm2) gradually decreased. No obvious adverse reactions (fever, edema, pain, skin itching, rash, or other sensory abnormalities) were observed in either the au-PRP or the al-PRP groups. Both al-PRP and au-PRP could effectively and safely promote wound healing in patients with DLEUs. Alternatively, al-PRP could be used for DLEUs as an off-the-shelf solution when au-PRP is limited. Registration number of clinical trials: ChiCTR1900021317

A novel Split-Thickness Skin Graft Donor Site

2009 ◽  
Vol 141 (3) ◽  
pp. 390-394 ◽  
Author(s):  
Tamer A. Ghanem ◽  
Mark K. Wax
Keyword(s):  
Skin Graft ◽  
Reverse Flow ◽  
Donor Site ◽  
Tertiary Care ◽  
Case Series ◽  
Free Flaps ◽  
Split Thickness Skin Graft ◽  
Skin Paddle ◽  
Forearm Flap ◽  
Thickness Skin

OBJECTIVE: To eliminate morbidity of the thigh split-thickness skin graft (STSG) donor site in forearm flaps, the feasibility of harvesting from an alternate site was assessed. STUDY DESIGN: Case series with planned data collection. SETTING: A tertiary care academic setting. SUBJECTS AND METHODS: Data were collected from patients undergoing forearm flap reconstruction over 13 months. The forearm flap harvesting procedure was modified to incorporate STSG harvest directly from the flap skin paddle. RESULTS: There were 66 patients in this cohort, with mean age of 62.6 years. There were 58 fasciocutaneous radial forearm free flaps (RFFFs), three osteocutaneous RFFF, three ulnar flaps, and two reverse-flow RFFFs. The majority of flaps were used for mucosal coverage (n = 54), but 12 flaps were used for external skin coverage. The mean forearm defect was 36.5 cm2 (12–77 cm2). Harvesting from the forearm skin paddle was successful in 64 patients (97%). Two patients required a thigh STSG; both patients were octogenarians with frail skin. CONCLUSION: A thigh STSG donor site, with its associated morbidities, can be eliminated in 97 percent of patients undergoing forearm flaps. Older patients with frail skin may require a thigh donor site.

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