The “biological chamber” method – use of autologous platelet-rich plasma (PRP) in the treatment of poorly healing lower-leg ulcers of venous origin

2015 ◽  
Vol 87 (6) ◽  
Author(s):  
Dariusz Waniczek ◽  
Wojciech Mikusek ◽  
Tomasz Kamiński ◽  
Mariusz Wesecki ◽  
Zbigniew Lorenc ◽  
...  

AbstractWound healing is a complex pathophysiological process, in which platelets play a crucial role. Platelet alpha-granules release growth factors to the wound bed; the factors are necessary in the healing process. In chronic wounds, such as poorly healing lower-leg ulcers of venous origin, there is decreased activity of multiple growth factors, so the concept of exogenous delivery of such factors seems a logical strategy. Platelet-rich plasma therapy in patients with lower-leg ulcers of venous origin combined with conventional treatment methods (previously ineffective in these patients) seems, based on our observation, an important adjunct leading to recovery.The aim of the study was to present an original method of autologous platelet-rich plasma application through the creation of a sort of “biological chamber” containing a concentrate of growth factors.Material and methods. The described therapy was implemented in 10 patients, who had been ineffectively treated for more than one year in the outpatient setting. Patients with exacerbation of inflammatory process, signs of wound infection and ankle brachial pressure index < 0.8 were excluded from the study. After the application of platelet-rich plasma, further treatment was continued with the use of moist therapy and compression therapy according to a uniform regimen.Results. Complete healing was achieved within 4-10 weeks from the beginning of the product administration in all patients.Conclusion. The presented method seems technically simple, effective and relatively inexpensive

Author(s):  
Firdaus A. Dekhaiya ◽  
Jignesh K. Joshi ◽  
Sarav Bamania

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


2021 ◽  
Vol 506 (1-2) ◽  
Author(s):  
Nguyen Ngoc Tuan ◽  
Nguyen Tran Ngoc Tu ◽  
Nguyen Tien Dung

Objective: Our aim was to evaluate topical EGF, VEGF, MMP12 concentrations of ​​chronic wounds which after Autologous Platelet - Rich Plasma(PRP) therapy. Methods: The study conducted a descriptive longitudinal study at the Wound Healing Center of the Vietnam National Burn Hospital from 11/2018 to 2/2020. 24 patients with chronic wounds and aged 18 years old or older were enrolled in this study. These patients were injected autologous PRP at wound bed. We biopsied chronic wound bed tissue for evaluating EGF, VEGF and MMP12 by the Elisa technique at the first, second and third week of follow-up. Results: After PRP therapy, topical EGF and VEGF concentration increased after 1 week of treatment. MMP12 concentraiton significantly reduced compaired to before PRP therapy. Conclusion: In addition to PRP therapy had a beneficial effect on cutaneous regeneration and wound healing of the chronic wound. The autologous PRP promoted the wound healing process byincreating topical EGF and VEGF, reducing MMP12 which known as a pro-inflammatiory mediator.


Chirurgia ◽  
2021 ◽  
Vol 34 (2) ◽  
Author(s):  
Walid M. GAMAL ◽  
Mohammed A. OMAR ◽  
Aly H. RASHWAN ◽  
Abdrheem F. MOHAMED

2020 ◽  
Vol 29 ◽  
pp. 096368972093142
Author(s):  
Min He ◽  
Xuewen Guo ◽  
Tao Li ◽  
Xiaoyan Jiang ◽  
Yan Chen ◽  
...  

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


2020 ◽  
Vol 73 (10) ◽  
pp. 2150-2155
Author(s):  
Igor D. Duzhiy ◽  
Andrii S. Nikolaienko ◽  
Vasyl M. Popadynets ◽  
Oleksandr V. Kravets ◽  
Igor Y. Hresko ◽  
...  

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.


Author(s):  
Ya.V. Rybalka

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.


2019 ◽  
Vol 16 (3) ◽  
pp. 788-792 ◽  
Author(s):  
Carolina D. Weller ◽  
Elizabeth E. Gardiner ◽  
Jane F. Arthur ◽  
Melissa Southey ◽  
Robert K. Andrews

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