scholarly journals Features of organ-saving foot amputation associated with ozone therapy, local application of autologous platelet-rich plasma and vacuum sanitization of postoperative wound in patients with ischemic-gangrenous form of diabetic foot syndrome

2021 ◽  
Vol 11 (5) ◽  
pp. 237-245
Author(s):  
V. D. Fundiur ◽  
V. K. Grodetskyi ◽  
S. O. Yakobchuk ◽  
O. Y. Khomko ◽  
I. M. Kozlovska ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Platelet Rich Plasma ◽  
Main Group ◽  
Diabetic Foot Syndrome ◽  
Local Application ◽  
Control Group ◽  
Ozone Therapy ◽  
Reparative Process ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Improvement of reparative process of the chronic wounds with the insufficiency of peripheral blood suppling in patients suffering from diabetes mellitus is an important issue requiring further investigation. An optimal choice of surgery, effective renewal of blood supply and active stimulation of tissue repair on the cellular level are essential components of success treatment of this problem.Objective of research: From 2017 to 2020, the efficiency of one of the variants of organ-saving surgery performed on 210 patients with an ischemic-gangrenous form of diabetic foot syndrome was studied.Materials and methods. Control group included 104 patients (49.52%), were the treatment carried out in accordance with the standard scheme. The main group (106 patients - 50.47%) in addition to the standard therapy have used regional ozone therapy, vacuum sanitization and local application of autologous platelet-rich plasma (APRP).Results. These proposed measures reduced the period of clinical treatment to 24±1,2 days in the main group compared to 37±2,4 in the control one. 2 years later, patients of the main group confirmed the formation of a foot stump functionally adapted for walking with angular dislocation of fragments of the cuboid and scaphoid bones.Two years after foot amputation due to the ischemic-gangrenous form of diabetic foot syndrome (DFS), the amount of repeated above knee amputations was 1.8 times higher in the control group in comparison with the main group, which is indicative of a reasonable use of the complex of activate a reparative process in the wound.Conclusions: The suggested modification of the organ-saving and partial foot amputation in patients with IV degree of ischemia and DFS is indicative of a possibility to perform such kind of surgery as a variant of choice.The complex of proposed additional measures including regional ozone therapy, vacuum sanitization and local administration of autologous platelet-rich plasma activates a reparative process of a chronic foot wound and promotes an effective treatment of patients with ischemic-gangrenous form of DFS.

scholarly journals PECULIARITIES OF PERFORMING ORGAN-SAVING AMPUTATION OF THE FOOT COMBINED WITH OZONE THERAPY, LOCAL APPLICATION OF AUTOLOGOUS PLATELET-RICH PLASMA AND VACUUM SANATION OF POSTOPERATIVE WOUND IN PATIENTS WITH ISCHEMIC-GANGRENOUS FORM OF DIABETIC FOOT SYNDROM

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
V.D. Fundiur ◽  
V.K. Grodetskyi ◽  
S.O. Yakobchuk ◽  
O.Y. Khomko ◽  
I.M. Kozlovska ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Platelet Rich Plasma ◽  
Main Group ◽  
Diabetic Foot Syndrome ◽  
Local Application ◽  
Control Group ◽  
Ozone Therapy ◽  
Reparative Process ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

A positive result of treatment of patients suffering from ischemic-gangrenous form ofdiabetic foot syndrome (DFS) becomes possible with an optimal choice of surgery,effective renewal of blood supply and active stimulation of tissue restoration processon the cellular level.Objective – to study efficiency of the suggested organ-saving variant of surgery combinedwith the use of a complex of auxiliary factors of a reparative process activation in thewound including regional ozone therapy, vacuum sanitation and local application ofautologous platelet-rich plasma (PRP).Material and methods. The treatment of 210 patients with ischemic-gangrenous formof diabetic foot syndrome was carried out from 2017 to 2020. The efficiency of one ofthe variants of organ-saving operative intervention was studied. In the control group -104 (49.52%), the treatment was carried out in accordance with the standard scheme.In the main group (106 patients - 50.47%), in addition to the standard scheme, regionalozone therapy, vacuum sanitation and local application of autologous-rich plasma(PRP) were carried out.Results. These measures reduced the period of treatment of patients in the hospital to24 ± 1.2 days in the main group compared to 37 ± 2, 4 in the control one. 2 years later, patients of the main group confirmed the formation of a foot stumpfunctionally adapted for walking with angular dislocation of fragments of the cuboidand scaphoid bones.Conclusions. The suggested modification of the organ-saving and partial foot amputationin patients with IV degree of ischemia and DFS is indicative of a possibility to performsuch kind of surgery as a variant of choice for patients with ischemic-gangrenousform of diabetic foot syndrome. The complex of auxiliary measures (regional ozonetherapy, vacuum sanitation and local administration of autologous platelet-rich plasma(APRP)), activates a reparative process of healing of a chronic foot wound whichenables to make the period of hospital staying for patients shorter – to 24±1,2 days inthe main group as compared to 37±2,4 days in the control one. Clinical observation ofa remote postoperative period (2 years later) confirms a possibility to form a foot stumpfunctionally adapted for walking with angular dislocation of fragments of the cuboidand scaphoid bones, functionally advantageous for supporting load.

scholarly journals Efficacy of autologous platelet-rich plasma on graft uptake in myringoplasty: a single-blinded randomized control trial

2022 ◽  
Vol 38 (1) ◽  
Author(s):  
R. Vignesh ◽  
V. Nirmal Coumare ◽  
S. Gopalakrishnan ◽  
P. Karthikeyan
Keyword(s):  
Otitis Media ◽  
Platelet Rich Plasma ◽  
Successful Outcome ◽  
Control Group ◽  
List Type ◽  
Graft Material ◽  
Group I ◽  
Autologous Platelet Rich Plasma ◽  
Conventional Myringoplasty ◽  
Autologous Platelet

Abstract Background and aim Chronic otitis media is defined as a chronic inflammation of the middle ear cleft producing irreversible pathological changes. The myringoplasty aims at the reconstruction of the tympanic membrane using a graft material. Autologous platelet-rich plasma can be used along with the graft to have a successful outcome. The aim of the study was to assess the efficacy of autologous platelet-rich plasma on graft uptake in myringoplasty. Methods This was a randomized controlled trial with a sample size of 76 patients. All patients were above 18 and below 55 years of age diagnosed with chronic suppurative otitis media and were planned for myringoplasty. The participants were randomly allotted to two groups by block randomization (block of 4). Intra-operatively, group I (n=38) received platelet-rich plasma–soaked gel foam and group II (n=38) was taken as the control group who received saline-soaked gel foam and examined by a blinded examiner at the end of 1st and 3rd months. Results The mean air-bone gap reduction post-operatively in the platelet-rich plasma group was 8.68 ± 4.8 (P value 0.034) and 6.05 ± 4.05 in the control group. The improvement in pure-tone average in the platelet-rich plasma group (P = 0.009) is more than that in the control group. The graft uptake was higher among the platelet-rich plasma group than the control group both at 1st and 3rd months (P value 0.049) which were statistically significant. Conclusion The present study concludes that the usage of platelet-rich plasma in the conventional myringoplasty technique has improved the success rate of graft uptake and reduced the graft migration. Trial registration Clinical Trials Registry-India (ICMR-NIMS) CTRI/2020/04/024416. Date of registration: 01/04/2020. Date of enrolment of the first participant to the trial: 06/04/2020. URL of the trial registry: http://www.ctri.nic.in. Highlights Usage of autologous platelet-rich plasma (PRP) in conventional myringoplasty in underlay technique. Assessment of graft uptake, percentage of perforation closure, and the audiological outcome. Significant mean reduction of ABG in the PRP group. Significant improvement in PTA average in the PRP group. Graft uptake and percentage of perforation closure were higher in the PRP group and the control group. PRP is also beneficial in revision cases.

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

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.

scholarly journals ON IMPROVING THE TREATMENT OF PATIENTS WITH CHRONIC WOUNDS OF VENOUS GENESIS

2019 ◽  
Vol 19 (3) ◽  
pp. 75-78
Author(s):  
Ya.V. Rybalka
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Control Group ◽  
Wound Area ◽  
Area Reduction ◽  
Autologous Platelet Rich Plasma ◽  
Group 2 ◽  
Autologous Platelet ◽  
Group 1

Introduction. The analysis of the effectiveness of applying autologous platelet-rich plasma was performed in order to improve the results of surgical treatment of patients with wounds that heal slowly. Materials. The study is based on the analysis of the treatment of 61 patients who suffered from slow-healing wounds of venous genesis with a diameter of no more than 8 cm on the lower extremities and took the treatment at the surgical ward. The proposed method was based on obtaining autologous enriched platelet plasma followed by its injection along the periphery of the wound. The degree of reduction of the wound surface area was assessed by the method of contact planimetry per day. The patients of the 1st group demonstrated the wound area reduction by 5.1 ± 0.6%, and the patients of the group 2 – by 1.8 ± 0.4% (p <0005). The results indicate an increase in the rate of wound healing in patients in group 1 compared with patients in group 2. During the entire follow-up period (12 weeks), complete wound epithelialisation occurred in 21 (70%) patients in group 1 and in 10 (33.3%) patients of the group 2. The wound area decreased by more than 50% in 6 patients of group 1 (20%) and in 2 (7%) patients of the control group. The wound area decreased less than by 50% in 3 patients in group 1 (10%), and in 19 patients in group 2 (60%). The use of PRP therapy has been proven to have a significant positive effect on the process of wound healing compared with the use of standard methods used for the control group. Conclusion: increase in the wound healing pace in patients of group 1 (test) compared with patients of group 2 (control) can be explained by using autologous platelet-enriched plasma as an additional means to the standard therapy.

Evaluation of plasma PDGF and VEGF levels after systemic administration of activated autologous platelet-rich plasma

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 409-412
Author(s):  
Karina Karina ◽  
Krista Ekaputri ◽  
Johannes Albert Biben ◽  
Imam Rosadi ◽  
Iis Rosliana ◽  
...  
Keyword(s):  
Growth Factor ◽  
Treatment Group ◽  
Platelet Rich Plasma ◽  
Chemical Activation ◽  
Venous Blood ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Prior History ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Introduction and Aim: Activated autologous platelet-rich plasma (aaPRP) is becoming a popular therapy to accelerate healing in the field of plastic surgery. Platelets, which are abundant in aaPRP, can release many growth factors including platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF). This study aims to examine the plasma levels of PDGF and VEGF in healthy subjects after intravenous administration of aaPRP.   Materials and Methods: Nine healthy patients with no prior history of metabolic disease were divided into two groups (control and experiment group). The treatment group which consists of six patients received intravenous aaPRP treatment. The preparation of aaPRP starts with the collection of 24 mL of whole blood in sodium citrate tubes followed a two-step centrifugation procedure and subsequent chemical activation. aaPRP was then administered intravenously to patients. Meanwhile, the control group received no intervention. Venous blood samples were taken before and one week after the treatment and the plasma PDGF and VEGF levels were determined by enzyme-linked immunosorbent assay (ELISA).   Results: The treatment group showed statistically significant increase in VEGF after 7 days compared to before aaPRP administration. However, the change in PDGF levels of the treatment group was unnotable.   Conclusion: The present findings indicate that intravenous administrations of activated aaPRP may increase plasma VEGF level up to 1 week after aaPRP administration.

scholarly journals The Effect of Autologous Platelet-Rich Plasma on Bone Regeneration by Autologous Mesenchymal Stem Cells Loaded onto Allogeneic Cancellous Bone Granules

2017 ◽  
Vol 203 (6) ◽  
pp. 327-338 ◽  
Author(s):  
Min Wook Joo ◽  
Seung Jae Chung ◽  
Seung Han Shin ◽  
Yang-Guk Chung
Keyword(s):  
Stem Cells ◽  
Bone Regeneration ◽  
Cancellous Bone ◽  
Platelet Rich Plasma ◽  
Bone Defects ◽  
Histological Evaluation ◽  
Control Group ◽  
Micro Ct ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

To develop a clinically effective bone regeneration strategy, we compared bone regeneration using allogeneic cancellous bone granule scaffolds loaded with autologous bone marrow-derived mesenchymal stem cells (BM-MSC) with or without autologous platelet-rich plasma (PRP). Critical-sized segmental bone defects were made at the mid-shaft of both radiuses in 41 New Zealand White rabbits. Small-sized allogeneic cancellous bone granules (300-700 μm in diameter) loaded with BM-MSC were implanted on one side, and PRP was added. On the other side, autologous BM-MSC loaded onto allogeneic cancellous granules were grafted as a control. Bone regeneration was assessed by radiographic evaluation at 4, 8, and 16 weeks postimplantation and by micro-computed tomography (micro-CT) and histological evaluation of the retrieved specimens at 8 and 16 weeks. The experimental group did not show significantly higher bone quantity indices than the control group at any time point. Micro-CT analysis revealed that both groups had similar mean total volumes, surface areas, and other parameters at 8 and 16 weeks. Histological evaluation of 8- and 16-week specimens also showed a similar progression of new bone formation and maturation. In this experiment using a contralateral control group in the same individual, an initial single addition of PRP in allogeneic cancellous bone granules loaded with BM-MSC for critical-sized bone defects in the weight-bearing area did not induce a consequent difference in bone healing. Further research into the optimal preparation and application of PRP is necessary. Furthermore, studies involving a greater number of subjects and larger experimental animals could determine the clinical relevance of PRP treatment.

scholarly journals Efficacy of autologous platelet rich plasma versus regular dressing in chronic wounds

2019 ◽  
Vol 6 (11) ◽  
pp. 4103
Author(s):  
Asif . ◽  
N. Chandramouli
Keyword(s):  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Test Group ◽  
Research Centre ◽  
Control Group ◽  
Percentage Decrease ◽  
Randomized Controlled Clinical Trials ◽  
Effective Treatment Modality ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Background: Chronic wounds are a frequent problem and pose a heavy burden to the service provider. Platelet extract containing several growth factors used on chronic wounds has shown impressive results in both healing percentage and time for epithelisation. Platelet extract from the patient’s own blood has been used in trials as a cheap and equally effective alternative to commercial platelet gels. The aim of the study was to demonstrate the therapeutic role of autologous platelet rich plasma (APRP) in epithelialisation and reduction in size of chronic wounds of lower limb.Methods: It is a case control study, conducted at Sri Adichunchanagiri Hospital and Research Centre, B.G. Nagara, Karnataka. Conducted during January 2017 to June 2018 this study consisted of 30 patients with chronic ulcers between the age group of 18-80 years, with duration of ulcer ranging from 12 to 26 weeks. After obtaining consent they were randomly allotted into control and test groups with 15 patients each. Control group patients were treated with conventional dressing and in test group APRP dressing was done. Later percentage decrease in wound size was assessed.Results: Ulcer size decreased significantly (p<0.0001) in test group compared to control group. No unwanted effects or complications noted.Conclusions: APRP is a safe and effective treatment modality for chronic non-healing ulcers. It enhances healing and also decreases the associated cost and morbidity. Further research and randomized controlled clinical trials on larger patient population are necessary to validate the results.

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