scholarly journals CGF treatment of leg ulcers: A randomized controlled trial

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 959-967 ◽  
Author(s):  
Bruno Amato ◽  
Michele Angelo Farina ◽  
Silvana Campisi ◽  
Marino Ciliberti ◽  
Vincenzo Di Donna ◽  
...  
Keyword(s):  
Growth Factors ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Healing Process ◽  
Randomized Study ◽  
Healing Time ◽  
Lower Limbs ◽  
Skin Ulcers ◽  
Stimulation System ◽  
Chronic Skin

AbstractBackgroundConcentrated Growth Factors (CGF) is a concentration of second generation autologous growth factors compared to platelet rich plasma (PRP) and represents a multifactorial stimulation system that can be used for the management and treatment of chronic skin ulcers.AimThe aim of this work is to evaluate the additional benefits of the CGF compared to the standard of dressing and its effects on the dynamics of the healing process.MethodsAutologous CGFs were obtained from 100 patients with chronic mixed ulcers (venous ulcers in patients with II stage claudication) of the lower limbs in a multicentric controlled randomized study.ResultsThe results showed a significant advantage in the use of CGF in association with cleansing and selective compression in the healing time and stabilization of mixed ulcers of the lower extremities.ConclusionsThese results support the CGF’s clinical use for improving clinical outcomes in mixed ulcers of the legs.

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

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

scholarly journals Role of Growth Factors in Cutaneous Wound Healing: A Review

1993 ◽  
Vol 4 (5) ◽  
pp. 729-760 ◽  
Author(s):  
Christopher P. Kiritsy ◽  
Samuel E. Lynch
Keyword(s):  
Wound Healing ◽  
Growth Factors ◽  
Healing Process ◽  
Repair Process ◽  
Wound Healing Process ◽  
Cutaneous Wounds ◽  
Skin Ulcers ◽  
Molecular Events ◽  
Chronic Skin ◽  
Preclinical Animal Models

The well-orchestrated, complex series of events resulting in the repair of cutaneous wounds are, at least in part, regulated by polypeptide growth factors. This review provides a detailed overview of the known functions, interactions, and mechanisms of action of growth factors in the context of the overall repair process in cutaneous wounds. An overview of the cellular and molecular events involved in soft tissue repair is initially presented, followed by a review of widely studied growth factors and a discussion of commonly utilized preclinical animal models. The article concludes with a summary of the preliminary results from human clinical trials evaluating the effects of growth factors in the healing of chronic skin ulcers. Throughout, the interactions among the growth factors in the wound-healing process are emphasized.

scholarly journals Il trattamento topico con una matrice contenente mesoglicano in associazione ad acido ialuronico nella gestione delle ulcere cutanee croniche degli arti inferiori/Topical treatment with a matrix containing mesoglycan in association with hyaluronic acid in the management of chronic skin ulcers of the lower limbs

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Rolando Tasinato ◽  
Paolo Zangrande
Keyword(s):  
Hyaluronic Acid ◽  
Povidone Iodine ◽  
Sono State ◽  
Lower Limbs ◽  
Iodine Solution ◽  
Skin Ulcers ◽  
Vascular Origin ◽  
Chronic Skin ◽  
Wound Bed Preparation ◽  
Povidone Iodine Solution

Un’ulcera cutanea cronica degli arti inferiori rappresenta l’epifenomeno di varie situazioni patologiche che possono coinvolgere, a vari livelli e con diversi gradi di interessamento, i sistemi venoso, arterioso e linfatico della gamba. Recentemente sono state pubblicate numerose evidenze secondo cui i glicosaminoglicani (GAG) svolgono un ruolo importante nella riepitelizzazione delle ulcere cutanee croniche degli arti inferiori, in particolare per quanto riguarda le ulcere ad eziopatogenesi vascolare venosa o mista. In questo articolo riportiamo la nostra esperienza nel trattamento delle ulcere cutanee croniche degli arti inferiori con una metodica che prevede il debridement secondo il protocollo TIME, antisepsi con una soluzione di iodopovidone al 10% la successiva l’applicazione di una medicazione bioattiva contenente GAG e acido ialuronico. Questa metodica è stata confrontata con un’analoga metodica che prevede sempre lo stesso tipo di debridement e di antisepsi con soluzione di iodopovidone al 10% affiancata a una medicazione non bioattiva. A chronic skin ulcer in the lower limbs represents the epiphenomenon of pathologies that may involve, at various levels, the venous, arterial, lymphatic and nervous systems of the leg, which must be identified and adequately treated. Recently, there has been increasing evidence that glycosaminoglycans (GAGs) play a role in the re-epithelialization of chronic skin ulcerative wounds of the lower limbs, particularly as regards ulcers of venous and arterial vascular origin. In this paper we report our experience in the treatment of chronic skin ulcers with debridement according to the TIME Wound Bed Preparation protocol with application of a bioactive dressing containing GAGs and hyaluronic acid, compared to a technique using a standard dressing involving the cleansing of the wound with 10% povidone iodine solution.

scholarly journals Skin-specific antibodies neutralizing mycolactone toxin during the spontaneous healing of Mycobacterium ulcerans infection

2020 ◽  
Vol 6 (9) ◽  
pp. eaax7781 ◽  
Author(s):  
Mélanie Foulon ◽  
Amélie Pouchin ◽  
Jérémy Manry ◽  
Fida Khater ◽  
Marie Robbe-Saule ◽  
...  
Keyword(s):  
Healing Process ◽  
Buruli Ulcer ◽  
Mycobacterium Ulcerans ◽  
World Health ◽  
Immunomodulatory Activity ◽  
Spontaneous Healing ◽  
Specific Antibodies ◽  
Skin Ulcers ◽  
Chronic Skin ◽  
Health Organization

Buruli ulcer, a neglected tropical infectious disease, is caused by Mycobacterium ulcerans. Without treatment, its lesions can progress to chronic skin ulcers, but spontaneous healing is observed in 5% of cases, suggesting the possible establishment of a host strategy counteracting the effects of M. ulcerans. We reveal here a skin-specific local humoral signature of the spontaneous healing process, associated with a rise in antibody-producing cells and specific recognition of mycolactone by the mouse IgG2a immunoglobulin subclass. We demonstrate the production of skin-specific antibodies neutralizing the immunomodulatory activity of the mycolactone toxin, and confirm the role of human host machinery in triggering effective local immune responses by the detection of anti-mycolactone antibodies in patients with Buruli ulcer. Our findings pave the way for substantial advances in both the diagnosis and treatment of Buruli ulcer in accordance with the most recent challenges issued by the World Health Organization.

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.

P–600 Ovarian function following intraovarian injection of autologous platelet rich plasma (APRP) in women with low functional ovarian reserve

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
D Barad ◽  
S K Darmon ◽  
A Benor ◽  
N Gleicher
Keyword(s):  
Growth Factors ◽  
Ovarian Reserve ◽  
Ovarian Function ◽  
Endometrial Thickness ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Autologous Blood ◽  
Poor Response ◽  
Medical Specialties ◽  
Menstruating Women

Abstract Study question Does exposure of ovaries to autologous growth factors in platelet rich plasma (APRP) affect the pituitary ovarian axis? Summary answer Within 60 days after injection, growing follicle numbers and estrogen levels increased, though FSH did not change, with effects most pronounced in still menstruating women. What is known already APRP is extracted from a patient’s autologous blood and delivers growth factors. It is widely used in several medical specialties and has in infertility practice been reported to increase folicle/egg numbers if injected into ovaries and improve endometrial thickness/implantation if used for perfusion of the endometrium. Study design, size, duration Prospective observational cohort study of women with low functional ovarian reserve, followed for 60 days after subcortical injection of ovaries. Participants/materials, setting, methods 44 women with prior poor response to ovulation induction, FSH > 12 mIU/mL and AMH < 1.0 ng/mL. APRP was prepared using Regen Lab PRP Kit which is approved by the US-FDA. 1.0–1.5 ml of PRP was injected into the cortex of each ovary divided among 7 to 10 injection sites. Participants were followed every three days with monitoring for estradiol, FSH and follicle growth for the first two weeks after PRP and then weekly. Main results and the role of chance 21/43 patients still regularly menstruated (subgroup A, age 43.9 ± 5.1 years); 23/43 (subgroup B, age 42.6 ± 6.2 years) were amenorrheic for a median of 6 months. In A, AMH, FSH and estradiol were 0.18 ± 0.20 ng/mL, 37.5 ± 47.6 mIU/mL, and 100.2 ± 73.4 pg/mL, while in B they were 0.06 ± 0.11 ng/mL, 73.0 ± 44.8 mIU/mL and 66.7 ± 57.6 pg/mL. Following APRP, A-patients demonstrated increased estradiol to 211 ± 193.7 pg/mL (P = 0.029) while B-patients only demonstrated a trend to 98.1 ± 86.5 (P = 0.09). Among A patients, 14/21 (66.7%) entered IVF cycles and 5/21 (23.8%) reached retrieval. So-far 1 patients established an ongoing clinical pregnancy. Among B patients 8/23 (34.8%) entered IVF cycles and only 2/23 (8.7%) reached retrieval and none achieved pregnancy. Limitations, reasons for caution This observational study was only carried out to estimate possible effects of APRP treatments. Based on these observations, we are now conducting a randomized controlled trial, limited to cycling women under age 45 years [registration # NCT04278313]. Wider implications of the findings: PRP appears to have limited ability to affect ovarian reserve of older, and especially amenorrheic women. It may, however, exert more favorable effects on still menstruating women. Promotion of APRP treatment as “ovarian rejuvenation,” however, appears to be an inappropriate choice of words. Trial registration number N/A

PLATELET FUNCTION AND ENDOCRINE STRESS RESPONSE DURING EPIDURAL AND GENERAL ANAESTHESIA FOR MINOR SURGERY OF THE LOWER LIMBS

1987 ◽  
Author(s):  
T H Nielsen ◽  
H K Nielsen ◽  
S E Husted ◽  
H C Husegaard ◽  
S L Hansen ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Platelet Function ◽  
Epidural Anaesthesia ◽  
Hip Replacement ◽  
Platelet Rich Plasma ◽  
Randomized Study ◽  
Lower Limbs ◽  
Thromboembolic Complications ◽  
Endocrine Stress Response ◽  
Minor Surgery

Postoperative frequency of deep venous thrombosis(DVT) is high, reported to be 13-59$ after abdominalsurgery and as high as 73$ after total hip replacement. Epidural anaesthesia can reduce the frequency ofDVT and pulmonary embolism. Platelet aggregation (PA) is supposed to play an important role in formationof DVT. In a randomized study twenty patients admitted to transarthroscopic meniscectomy were allocated to epidural or general anaesthesia. All operations were carried out in blood less field using a thigh tourniquet. S-cortisol, thromboxane-B2 (TxB2) and PAwere measured before premedication, before Itart of the operation and finally before and lo min after exsufflation of the tourniquet. Aggregability was measured in platelet -rich plasma and expressed as the treshold concentration of collagen and ADP. S-cortisol and TxB2 were measured by RIA. Collagen induced TxB2-synthesis in platelet-rich plasma was significanthigher during general as compared with epidural anaesthesia (p<o.o5). Furthermore, s-cortisol significantly decreased in the epidural and increased in thegeneral anaesthesia group (p<o.o5). Treshold concentration of collagen and ADP did not differbetween the two groups, and removal of the thigh tourniquet did not influence any of the measured variables. It is concluded, thatthe adrenocortical system is activatedduring general and inhibited duringepidural anaesthesia. As a possible concequence the platelet function is enhanced during general anaesthesia, increasingthe risk of thromboembolic complications

scholarly journals Infiltration of Autologous Growth Factors in Chronic Tendinopathies

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Antonio Crescibene ◽  
Marcello Napolitano ◽  
Raffaella Sbano ◽  
Enrico Costabile ◽  
Hesham Almolla
Keyword(s):  
Growth Factors ◽  
Functional Recovery ◽  
Sports Medicine ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Achilles Tendinopathy ◽  
Patellar Tendinopathy ◽  
Instrumental Evaluation ◽  
Therapeutic Alternative

Achilles tendinopathy and patellar tendinopathy are among the most frequent diagnoses in sports medicine. Therapeutic treatment of the disease is difficult, particularly in chronic cases. In literature, several studies suggest the employment of Platelet-Rich Plasma as a therapeutic alternative in tendinopathies. The choice of employing this method is based on the activity of growth factors contained in platelets which activate, amplify, and optimize the healing process. We selected 14 patients affected by Achilles tendinopathy and 7 patients affected by patellar tendinopathy, with a two-year final follow-up. These patients underwent a cycle of three tendinous infiltrations, after clinical and instrumental evaluation carried out by means of specific questionnaires and repeated ultrasound scans. Ultrasound scans of 18 patients showed signs of reduction in insertional irregularities. The result is confirmed by complete functional recovery of the patients, with painful symptomatology disappearing. The patients showed a clear pain reduction, along with an enhanced VISA score after the 24-month follow-up, equal to 84.2 points on a scale of 0 to 100. In conclusion, the present study provides evidence to suggest that PRP infiltration is a valid option to patients with chronic tendinopathy who did not benefit from other treatments.

scholarly journals Ovarian Rejuvenation Using Autologous Platelet-Rich Plasma

Endocrines ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 15-27
Author(s):  
Tuyen Kim Cat Vo ◽  
Yuka Tanaka ◽  
Kazuhiro Kawamura
Keyword(s):  
Growth Factors ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Infertility Treatment ◽  
Published Data ◽  
High Concentration ◽  
Treatment Needs ◽  
Initial Report ◽  
Plasma Fraction ◽  
Autologous Platelet Rich Plasma

Advanced maternal age is associated with the natural oocyte depletion, leading to low oocyte yield, high infertility treatment cancellation rates, and eventual decreases in pregnancy rates. Various innovative interventions have been introduced to improve the outcome of infertility treatment for aging patients. Numerous published data demonstrated that early follicle development was regulated by intraovarian growth factors through autocrine or paracrine mechanisms. Platelet-rich plasma (PRP), a plasma fraction of peripheral blood with a high concentration of platelets, has been implemented in regenerative medicine in the last decade. The plasma contains a variety of growth factors that were suggested to be able to enhance angiogenesis regeneration and the cell proliferation process. The initial report showed that an intraovarian injection of PRP improved the hormonal profile and increased the number of retrieved oocytes in patients with diminished ovarian reserve. Subsequently, several studies with larger sample sizes have reported that this approach resulted in several healthy live births with no apparent complications. However, the use of ovarian PRP treatment needs to be fully investigated, because no randomized controlled trial has yet been performed to confirm its efficacy.

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