Effectiveness of autologous platelet-rich plasma gel in the treatment of hard-to-heal leg ulcers: a randomised control trial

Objective: Regenerative medicine products such as autologous platelet-rich plasma (autologous PRP) gel may speed up the process of healing. Clinical studies show promising results in the treatment of diabetic foot ulcers (DFUs), however there is lack of scientific evidence of autologous PRP effectiveness in treating leg ulcers of other aetiology. This study evaluates the effectiveness of autologous PRP gel in the treatment of hard-to-heal leg ulcers compared with existing conventional treatment. Method: A prospective, randomised controlled, open-labelled clinical trial was carried out between 2014 and 2018. An eight-week study protocol was chosen or until 100% wound re-epithelialisation was observed. Wound size reduction, granulation tissue formation, microbiological wound bed changes and safety were evaluated. Results: A total of 69 patients (35 in the autologous PRP group and 34 in the control group) were included in the study; 25.71% of the autologous PRP group and 17.64% of control group had ulcers completely re-epithelialised (p>0.05). Wound size reduction in the autologous PRP group was 52.35% and 33.36% in the control group (p=0.003). The autologous PRP group showed superiority over conventional treatment in wound bed coverage with granulation (p=0.001). However, more frequent wound contamination was observed at the end of treatment in the autologous PRP group (p=0.024). No severe adverse events were noted during the study. Both treatment methods were considered equally safe. Conclusion: Topical application of autologous PRP gel in leg ulcers of various aetiology show beneficial results in wound size reduction and induces the granulation tissue formation. However, it is associated with more frequent microbiological wound contamination.

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Autologous Platelet-rich Plasma Versus Conventional Dressing in Treatment of Chronic Venous Leg Ulcers

QJM ◽

10.1093/qjmed/hcab097.002 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hesham Adel Alaa Aldein ◽

Wafi Fouad Salib ◽

Ramy Mikhael Nageeb ◽

Abdelrahman Ahmed Mohamed ◽

Ahmad Farid Elsayed Mostafa Radwan

Keyword(s):

Platelet Rich Plasma ◽

Compression Therapy ◽

Control Group ◽

Study Group ◽

Leg Ulcers ◽

Venous Leg Ulcers ◽

Venous Ulcers ◽

Autologous Platelet Rich Plasma ◽

Autologous Platelet

Abstract Background Prevalence of active venous leg ulcers was reported to be around 0.5% in different populations severely reduces quality of life, and increases the cost of health care. Management of VLUs include many modalities to obtain good result and improving patients life-style, these modalities include compression therapy, medical treatment, surgical and interventional procedures and local wound care. Objective: To compare between autologous platelet rich plasma and saline dressing in treatment of chronic leg venous ulcer concerning reduction of ulcer area. Patients and Methods That prospective study included 40 patients with chronic venous leg ulcers recruited from Ain shams university hospitals for whom treatment with PRP was done for 20 patients weekly for up to 3 weeks(one session of injection per week)(study group) and applying saline dressing for 20 patients(control group) in addition to compression therapy and follow up for4 months. Our objective was to compare rate of wound healing. Results A total of 44 venous ulcers from 40 patients who met the inclusion criteria were treated. Application of PRP was done for 20 patients weekly for up to 3 weeks(one session of injection per week)(study group) and applying saline dressing for 20 patients(control group) in addition to compression therapy and follow up for4 months. Conclusion We can draw the conclusion our study's results reveal that the use of PRP contributes to improving the results of treatment of venous ulcers and that it is an effective and safe therapy. Nonetheless, we need to consider that application of this or any other treatment should always be accompanied by the necessary management of the underlying disease, in addition to a suitable pressure bandage that improves venous return and facilitates favourable clinical course of lesions.

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

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00190-x ◽

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.

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Effectivity of topical mangosteen pericarp extract cream on wound healing in Swiss albino mice

Journal of Biological Research - Bollettino della Società Italiana di Biologia Sperimentale ◽

10.4081/jbr.2019.8150 ◽

2019 ◽

Vol 92 (2) ◽

Author(s):

Hilda Brigitta Sombolayuk ◽

Khairuddin Djawad ◽

Siswanto Wahab ◽

Upik A. Miskad ◽

Gemini Alam ◽

...

Keyword(s):

Wound Healing ◽

Granulation Tissue ◽

Inflammatory Cells ◽

Control Group ◽

Tissue Formation ◽

Granulation Tissue Formation ◽

Swiss Albino Mice ◽

Accelerate Wound Healing ◽

Acute Wound ◽

Albino Mice

Wound healing is a complex physiological process consisting of four phases: coagulation, inflammation, proliferation and migration, and remodeling, each with distinct characteristics. Studies have suggested that mangosteen pericarp extract (MPE) may accelerate wound healing. However, the mechanism has not been fully understood. This study aims to evaluate the effect of MPE cream in various concentrations in acute wound healing of albino mice, both histologically and macroscopically. Thirty-two healthy female Swiss albino mice, aged 6-9 weeks, weight 20-30 g, were included in this study. The samples were randomly divided into eight groups each consisting of 4 mice. The first four groups were treated with MPE cream 5%, 10%, and 20%, and no medication (control group), respectively, and were sacrificed after three days. The other four groups received the same application and were sacrificed after 8 days. Wound bed diameter was measured and biopsy from the skin lesion was performed for histopathologic examination. Mann-Whitney test was used to analyze the diameter of the wound bed and histopathological findings of granulation tissue formation, reepithelialization, and inflammation, with P<0.05 considered as significant. MPE cream significantly improved wound healing by increasing granulation tissue formation, and reepithelialization. In addition, MPE cream application was also shown to decrease the number of inflammatory cells, particularly in 5% and 10% concentrations, both in the 3-day and 8-day groups. MPE cream application can accelerate wound healing and thus can be used in acute wound treatment.

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Autologous platelet-rich plasma in treatment of chronic venous leg ulcers: A prospective case series

Vascular ◽

10.1177/1708538114563824 ◽

2014 ◽

Vol 23 (6) ◽

pp. 580-585 ◽

Cited By ~ 6

Author(s):

Seyhan Yilmaz ◽

Eray Aksoy ◽

Suat Doganci ◽

Adnan Yalcinkaya ◽

Adem I Diken ◽

...

Keyword(s):

Platelet Rich Plasma ◽

Case Series ◽

Leg Ulcers ◽

Wound Surface ◽

Wound Area ◽

Venous Leg Ulcers ◽

Venous Ulcers ◽

Autologous Platelet Rich Plasma ◽

Prospective Case Series ◽

Complete Wound Healing

StudyWe report our results on a case series of 19 patients receiving platelet-rich plasma application in treatment of patients with chronic unhealing venous leg ulcers.Material and methodsThere were 16 males and three females with a mean age of 38.55 ± 16.46 years. Planimetric size measurements were performed and pain was tested throughout the treatment period. Follow-up was made in seven-day periods. Patients received 5 ml of platelet-rich plasma for each 5 cm2of the wound surface with half of the amount being injected 1–2 mm deep into the wound and the wound surface was covered with the remaining half.ResultsComplete wound healing occurred in 18 of 19 patients (94.7%) within a mean of 4.82 ± 2.16 week. There were significant reductions in wound area among all consecutive measurements except for first week. A significant reduction in wound volume was apparent even in first week and sustained among consecutive measurements.ConclusionPlatelet-rich plasma seems effective in terms of promoting healing of venous leg ulcers. Improvement in wound depth was slightly more prominent than that in wound area, indicating a potential role of platelet-rich plasma especially in deep venous ulcers.

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CLINICAL AND HISTOPATHOLOGICAL EVALUATION OF USING PLATELET-RICH PLASMA AND PLATELET-RICH FIBRIN MATRIX IN TREATMENT OF INDUCED CHRONIC OPEN WOUNDS IN BUCKS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i5.24105 ◽

2018 ◽

Vol 11 (5) ◽

pp. 337 ◽

Cited By ~ 3

Author(s):

Falah H Khalaf ◽

Serwa Ibrahim Salih

Keyword(s):

Chronic Wound ◽

Platelet Rich Plasma ◽

Healing Process ◽

Experimental Period ◽

Control Group ◽

Full Thickness ◽

Platelet Rich Fibrin ◽

Fibrin Matrix ◽

Four Square ◽

Prp Gel

Objective: This study was designed to identify the effectiveness of platelet-rich plasma gel (PRP) and platelet-rich fibrin matrix (PRF) application on the induced open chronic full-thickness cutaneous wounds in goats.Methods: A total of 24 adult apparently healthy local breed bucks were used in this study. PRP gel and PRF matrix were prepared from whole blood at the time of treatment, four square full-thickness skin wounds (4 cm × 4 cm) on the dorsal sides of the back of each animal were created, by daily scratched to interrupt healing process continuation to prolong inflammatory reaction to form chronic wound, this surgical procedure was continued for 8 weeks to ensure the traditional chronicity wounds, after that they were treated by PRP gel in the first group (n=12), while PRF matrix was used in the second group (n=12). Each group was also subdivided into treatment (n=2 wounds) and control group (n=2 wounds) in each animal. The healing process was evaluated by clinical examination during experimental period and histologically in day 7, 14, 28, and 45 post operation.Conclusion: Both groups showed faster tissue repair and epithelialization in treatment groups compared to control groups. The results of this study confirmed PRP gel and PRF matrix application improved and accelerated cutaneous open chronic wound healing.

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RapidlyIn SituForming Platelet-Rich Plasma Gel Enhances Angiogenic Responses and Augments Early Wound Healing after Open Abdomen

Gastroenterology Research and Practice ◽

10.1155/2013/926764 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 14

Author(s):

Bo Zhou ◽

Jianan Ren ◽

Chao Ding ◽

Yin Wu ◽

Dong Hu ◽

...

Keyword(s):

Wound Healing ◽

Growth Factor ◽

Granulation Tissue ◽

Open Abdomen ◽

Transforming Growth Factor ◽

Platelet Rich Plasma ◽

Tissue Formation ◽

Granulation Tissue Formation ◽

Abdominal Hypertension ◽

Early Wound

Objective.The purposes of our present study were to evaluate the potential of platelet-rich plasma gel to enhance granulation tissue formation after open abdomen and to examine whether the effect was attributable to stimulating rapid neovascularization.Methods.Twenty-four rats underwent colon ascendens stent peritonitis surgery to induce sepsis, followed by intraperitoneal injection of nitrogen to create intra-abdominal hypertension. Four hours later, laparotomies were performed. The rats were randomized into three groups (n=8for each group): control, platelet-poor plasma (PPP), and platelet-rich plasma (PRP) groups. One week after the treatment, granulation tissue formation and angiogenesis were evaluated by histological and laser Doppler analysis.Results.The resultant platelet count in platelet-rich plasma was higher than that of PPP. The concentrations of platelet-derived growth factor BB, transforming growth factorβ-1, and vascular endothelial growth factor in PRP were significantly higher when compared with that of PPP. Myofibroblast count, granulation tissue thickness, vessel numbers, and blood perfusion were increased in PRP group, followed by PPP group, with control being the least.Conclusion.Rapidlyin situforming platelet-rich plasma gel promoted remarkable neovascularization and early wound healing after open abdomen and may lead to novel and effective treatments for open abdominal wounds.

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Enhancement of vascularization and granulation tissue formation by growth factors in human platelet-rich plasma-containing fragmin/protamine microparticles

Journal of Biomedical Materials Research Part B Applied Biomaterials ◽

10.1002/jbm.b.31824 ◽

2011 ◽

Vol 97B (2) ◽

pp. 373-380 ◽

Cited By ~ 37

Author(s):

Megumi Takikawa ◽

Shin-Ichiro Nakamura ◽

Shingo Nakamura ◽

Masaki Nambu ◽

Masayuki Ishihara ◽

...

Keyword(s):

Growth Factors ◽

Granulation Tissue ◽

Human Platelet ◽

Platelet Rich Plasma ◽

Tissue Formation ◽

Granulation Tissue Formation

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Healing Effects of Human Amniotic Membrane and Burned Wool on the Second-degree Burn in Rats

Galen Medical Journal ◽

10.31661/gmj.v9i0.1759 ◽

2020 ◽

Vol 9 ◽

pp. 1759

Author(s):

Nader Tanideh ◽

Farideh Keshavarzi ◽

Aida Hemat Zadeh ◽

Sajad Daneshi ◽

Omid Koohi-Hosseinabadi ◽

...

Keyword(s):

Wound Healing ◽

Amniotic Membrane ◽

Granulation Tissue ◽

Male Rats ◽

Control Group ◽

Human Amniotic Membrane ◽

Tissue Formation ◽

Granulation Tissue Formation ◽

Degree Burn ◽

Second Degree

ackground: This study aimed to compare sheep burnt wool and human amniotic membrane (AM) on second-degree burn wound healing in rats. Materials and Methods: Seventy-two adult male rats of Sprague Dawley underwent general anesthesia, and a deep second-degree burn was created on their skin by a hot iron plate. Afterward, human AM, silver sulfadiazine ointment (SSD), and sheep burned wool were used on wound area for burn treatment. On days 7, 14, and 21 of the experiment, the rats were sacrificed, and histopathological assessments were done. Results: Human AM, in comparison with other groups, significantly (P<0.05) showed better improvement in all pathologic variables. Burned wool showed significant improvement compared to the control group on day 7 in the angiogenesis, on day 14 in granulation tissue formation and epithelial formation, and on day 21 in new epithelial formation (P<0.05). Burned wool compared with SSD ointment in granulation tissue formation improved significantly (P<0.05) on days 7 and 14. Also, SSD ointment in comparison with the control group significantly improved (P<0.05) granulation tissue formation and macrophage on day 7. Conclusion: Human AM has a significant effect on the treatment of second-degree burn. Burned wool has a better effect on wound healing than SSD ointment and negative control group without treatment in terms of granulation tissue and epithelium formation. [GMJ.2020;9:e1759]

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

Актуальні проблеми сучасної медицини Вісник Української медичної стоматологічної академії ◽

10.31718/2077-1096.19.3.75 ◽

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.

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