Treatment of a Refractory Skin Ulcer Using Punch Graft and Autologous Platelet-Rich Plasma

Background. Chronic ulceration of the lower legs is a relatively common condition amongst adults: one that causes pain and social distress and results in considerable healthcare and personal costs. The technique of punch grafting offers an alternative approach to the treatment of ulcers of the lower limbs.Objective. Combining platelet-rich plasma and skin graft enhances the efficacy of treating chronic diabetic wounds by enhancing healing rate and decreasing recurrence rate. Platelet-rich plasma could, by stimulating dermal regeneration, increase the take rate after skin grafting or speed up reepithelialization.Methods and Materials. The ulcer was prepared by removing fibrin with a curette and the edges of the ulcer were freshened. The platelet-rich plasma has been infiltrated on the bottom and edges of the ulcer. The punch grafts were placed in 5 mm holes arranged. The ulcer was medicated with hydrogel and a pressure dressing was removed after 8 days.Results. After a few days the patient did not report more pain. Granulation tissue appeared quickly between implants. Most of the grafts were viable in 2-3 weeks. The grafts gradually came together to close the ulcer and were completed in four months.

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ROLE OF PLATELET RICH PLASMA IN TREATMENT OF CHRONIC NON-HEALING VENOUS ULCER

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i2.982 ◽

2020 ◽

Vol 4 (2) ◽

Author(s):

Firdaus A. Dekhaiya ◽

Jignesh K. Joshi ◽

Sarav Bamania

Keyword(s):

Growth Factors ◽

Platelet Rich Plasma ◽

Autologous Blood ◽

Healing Process ◽

Venous Ulcer ◽

Lower Limbs ◽

Venous Ulcers ◽

Autologous Platelet Rich Plasma ◽

Adhesive Proteins ◽

Autologous Platelet

Introduction: Venous ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the lower limbs. Considering that PRP is a source of growth factors, and consequently has mitogenic, angiogenic, and chemotactic properties, it represents an adjunctive treatment for recalcitrant wounds. Moreover, PRP provides the wound with adhesive proteins, such as fibrinogen, which are important in wound healing. PRP contain more amount of platelets, cytokines and growth factors which are dispersed in a very small amount of plasma which can be prepared from a sample of centrifuged autologous blood. Application of PRP has been reported to be effective in both acute as well as chronic non healing venous ulcers. Aim and Objective: To evaluate the efficacy of autologous platelet rich plasma in the management of chronic venous ulcer. Material and Method: A Prospective study conducted on 100 patients of chronic venous ulcers admitted in Sir T. Hospital Bhavnagar from June 2018 to June 2019 after fulfilled our inclusion and exclusion criteria. PRP then injected intalesionally inside and around the periphery of the wound/ulcer. This process was done once/week for 12 weeks. At every week, the area and volume of ulcer was calculated and photographs were taken. Result: All the patients showed healing of the ulcer with reduction in size of ulcer more than 90% was observed in 72 patients, followed by 80–90% reduction in wound size in 18 patients after the 12 weeks follow-up. Overall, significant reduction in size of ulcer was observed in all the treated patients. Conclusion: Autologous platelet rich plasma (PRP) as an autologous method, it is biocompatible, simple, safe, affordable and less expensive procedure in the treatment of chronic venous ulcers. PRP is found to be useful in improving and enhancing the healing process in chronic venous leg ulcers without any side effect. Keywords: Venous ulcer, Platelet rich plasma

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REPARATIVE PROCESSES FEATURES IN TROPHIC ULCERS CAUSED BY DIABETES MELLITUS WITH THE USE OF PLATELET-RICH PLASMA

Wiadomości Lekarskie ◽

10.36740/wlek202010108 ◽

2020 ◽

Vol 73 (10) ◽

pp. 2150-2155

Author(s):

Igor D. Duzhiy ◽

Andrii S. Nikolaienko ◽

Vasyl M. Popadynets ◽

Oleksandr V. Kravets ◽

Igor Y. Hresko ◽

...

Keyword(s):

Diabetes Mellitus ◽

Growth Factors ◽

Comparison Group ◽

Platelet Rich Plasma ◽

Main Group ◽

Lower Limbs ◽

Before And After ◽

Autologous Platelet Rich Plasma ◽

Inflammatory Changes ◽

Autologous Platelet

The aim: Was following: the improvement of the treatment results of the lower limbs ulcers, caused by the diabetes mellitus by using our technique of the platelet-rich plasma application; the study of the features of the morphological and immunohistochemical changes, and the effect of the growth factors of the platelet-rich plasma on the regeneration and healing of the ulcers. Materials and methods: 38 patients with the trophic ulcers of the lower limbs, caused by diabetes mellitus were involved in the study. To assess the morphological features of the reparative processes before and after the treatment with PRP, the histological and immunohystochemical studies of the biopsy specimen of ulcers were carried out. Results: The total epithelialization of the ulcers in the patients from the main group was achieved on 46.5 day, and in the comparison group – 81.7 day. The light and optical study of the specimen of the main group, using the autologous platelet-rich plasma revealed the elimination of the destructive changes and reduction of the mixed-cellular infiltration compared to the patients from the comparison group. The immunohystochemical study revealed the increase of the growth factors receptors. Conclusions: The usage of the autologous platelet-rich plasma in the treatment of the trophic ulcers results in the rapid regeneration by the decrease of the destructive and inflammatory changes as well as the improvement of the vascularization.

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The combined use of ozone therapy and autologous platelet-rich plasma as an alternative approach to foot rot treatment for sheep. A preliminary study

Small Ruminant Research ◽

10.1016/j.smallrumres.2017.08.015 ◽

2017 ◽

Vol 156 ◽

pp. 50-56 ◽

Cited By ~ 4

Author(s):

T. Szponder ◽

J. Wessely-Szponder ◽

M. Świeca ◽

A. Smolira ◽

T. Gruszecki

Keyword(s):

Platelet Rich Plasma ◽

Foot Rot ◽

Ozone Therapy ◽

Combined Use ◽

Alternative Approach ◽

Autologous Platelet Rich Plasma ◽

Preliminary Study ◽

Autologous Platelet

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Effects of Breed/Species and Gender on Platelet Concentration in Autologous Platelet Rich Plasma

Acta veterinaria ◽

10.2478/acve-2018-0038 ◽

2018 ◽

Vol 68 (4) ◽

pp. 474-483 ◽

Cited By ~ 1

Author(s):

Stephania Miranda ◽

Maria Fernanda De Mello Costa ◽

Juliana Jeunon Senna ◽

João Castañon Frapoint ◽

Nayro Xavier De Alencar ◽

...

Keyword(s):

Immune Status ◽

Platelet Rich Plasma ◽

High Concentration ◽

Platelet Concentration ◽

Speed Up ◽

Autologous Platelet Rich Plasma ◽

And Gender ◽

Preparation And Evaluation ◽

Autologous Platelet ◽

Factor Concentration

Abstract Platelet rich plasma (PRP) is an autologous biological product harvested by consecutive centrifugations of whole blood and separation of plasma in a stepwise protocol. PRP has been successfully used to stimulate healing in orthopedic and dermatological conditions, both in humans and animals. The principle is the fact that α- granules inside platelets contain a high concentration of growth factors, that once released can interfere with cellular communication and speed up healing. Standardization of PRP requires establishing a gold standard for the preparation and evaluation of the product, especially considering that platelet concentration and, therefore, growth factor concentration, might vary due to a number of variables. Factors such as age, gender, race or breed, and immune status of the patient might interfere with PRP quality and with treatment results, although little is known about such interferences. This research investigated the effect of breed/species and gender in platelet concentration in autologous PRP from horses and mules. The results demonstrate that Quarter Horses provided PRP with the greatest amount of platelets, although mules had a higher concentration percentages in relation to the initial platelet counts.

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TO STUDY THE EFFICACY OF AUTOLOGOUS PLATELET RICH PLASMA OVER CONVENTIONAL MECHANICAL FIXATION METHODS IN SPLIT THICKNESS SKIN GRAFTING

10.36106/gjra/9710378 ◽

2021 ◽

pp. 1-4

Author(s):

Ankur Deshwali ◽

Peeyush Kesharwani ◽

Rohan Gupta

Keyword(s):

Skin Graft ◽

Platelet Rich Plasma ◽

Skin Grafting ◽

Controlled Study ◽

Study Group ◽

Fixation Methods ◽

Thickness Skin ◽

Split Thickness Skin Grafting ◽

Autologous Platelet Rich Plasma ◽

Autologous Platelet

TITLE Efficacy of autologous platelet rich plasma over conventional mechanical fixation methods in split thickness skin grafting . AIMS AND OBJECTIVES to determine the efficacy of autologous platelet rich plasma over conventional mechanical fixation methods in split thickness skin grafting. METHODS  This a prospective randomized controlled study, conducted in the Department of surgery, SAIMS Medical College and P.G Institute, Indore for a period of two years from September 2016 to September 2018. A total of 20 patients were included in the study, and divided into two groups of 10 each randomly. The study was approved by the local ethical committee of our hospital. An informed written consent was obtained from all patients.  Total of 20 patients were studied; 10 cases were randomly chosen for study with autologous platelet rich plasma and 10 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. CONCLUSION  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.

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