Efficacy and Safety of Intralesional Platelet Rich Plasma (PRP) Therapy in the Management of Chronic Non-healing Leg Ulcers in our Population

2021 ◽  
Vol 15 (10) ◽  
pp. 2746-2748
Author(s):  
Muhammad Aslam Javed ◽  
Sadaf Amin ◽  
Wishal Raza ◽  
Imran Yousuf
Keyword(s):  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Simple Procedure ◽  
Cost Effective ◽  
Leg Ulcers ◽  
Weekly Basis ◽  
Time Period ◽  
Percentage Improvement ◽  
Chronic Ulcers ◽  
Chronic Leg Ulcers

Background: Autologous Platelets Rich Plasma (PRP) therapy not only hastens chronic wounds and ulcers healing but also diminishes the rate of amputations of lower leg caused by non-healing recalcitrant ulcers. In this study we have demonstrated the magical results of intralesional autologous PRP in the healing of resistant to heal chronic leg ulcers. Methods: In this metacentric study 26 patients having 30 chronic leg ulcers of more than 6 weeks duration and various etiologies, were treated with intralesional autologous PRP application on weekly basis for a duration of 8 weeks and the final results were calculated by percentage improvement in the volume and area of the ulcer/wound. Results: In our study 26 patient with 30 chronic recalcitrant leg ulcers/wounds were treated with intralesional autologous PRP therapy on weekly basis. Mean age of the included patients was 34.5 years. 19 were male patients and 7 were female. The mean time period of the healing of chronic ulcers was 5.3 weeks. The final mean percentage improvement outcome in the volume and area of the ulcers was calculated as 86% and 88% respectively. Conclusions: PRP therapy is safe, cost effective office based simple procedure in treating recalcitrant chronic leg ulcer/wounds. Keywords: Non-healing, intralesional, autologous platelet rich plasma, chronic ulcers

scholarly journals Efficacy of platelet rich plasma in chronic leg ulcers: a prospective randomized controlled study

2020 ◽  
Vol 7 (1) ◽  
pp. 78
Author(s):  
Naphisabet Wanniang ◽  
Pankaj Shukla ◽  
Varadraj V. Pai
Keyword(s):  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
The United States ◽  
Complete Healing ◽  
Controlled Study ◽  
Control Group ◽  
Leg Ulcers ◽  
The Mean ◽  
Chronic Leg Ulcers ◽  
Area And Volume

<p class="abstract"><strong>Background:</strong> Chronic wounds affect approximately 1-2% of the population in Europe and the United States. Platelet rich plasma (PRP) has emerged as an effective, inexpensive, minimally invasive treatment modality for chronic leg ulcers. Objective of the study was to evaluate the efficacy of PRP, and to compare the effectiveness of PRP to regular antiseptic dressing in the management of chronic leg ulcers.</p><p class="abstract"><strong>Methods:</strong> A hundred patients with chronic leg ulcers of more than 6 weeks duration were randomized into two groups (PRP and conventional dressing group). Patients in the PRP group received weekly intradermal injections of PRP to the wound in addition to conventional daily dressings till complete healing of the ulcers or up to a maximum of 6 weekly PRP sessions. Percentage of improvement in the area and volume of the ulcers were recorded. Patients were followed up at 1 month post PRP treatment.</p><p class="abstract"><strong>Results:</strong> The mean reduction in the area of the ulcers at the end of 6 weeks was 66.39% in the PRP group and 28.6% in the control group. The mean reduction in volume of the ulcers at the end of 6 weeks was 71.80% and 37.88% in the case and control group respectively. At the end of 1 month post treatment follow-up, 74% and 10% of the ulcers treated with PRP and with conventional dressing respectively showed complete healing.</p><p class="abstract"><strong>Conclusions:</strong> Leg ulcers treated with PRP showed a significantly higher reduction in the area and volume of the ulcers compared to ulcers treated with conventional moist dressing.</p>

scholarly journals Experience in the complex therapy of chronic leg ulcers

2021 ◽  
Vol 43 (3) ◽  
pp. 28-30
Author(s):  
A. B. Gataullin
Keyword(s):  
Hospital Setting ◽  
Leg Ulcers ◽  
Complex Therapy ◽  
Chronic Ulcers ◽  
Chronic Leg Ulcers

With patients suffering from chronic ulcers of the legs, it is necessary to meet a practical doctor relatively often both in a hospital setting and in a clinic. At the same time, despite the variety of methods of their treatment, the percentage of failures is still significant.

Treatment of therapy-refractive ulcera cruris of various origins with autologous keratinocytes in fibrin sealant

VASA ◽  
2005 ◽  
Vol 34 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Johnsen ◽  
Ermuth ◽  
Tanczos ◽  
Bannasch ◽  
Horch ◽  
...  
Keyword(s):  
Observational Study ◽  
Fibrin Sealant ◽  
Chronic Wounds ◽  
Leg Ulcers ◽  
Impaired Wound Healing ◽  
Skin Excision ◽  
The Mean ◽  
High Degree ◽  
Chronic Leg Ulcers ◽  
Suspended Cells

Background: Evaluation of the effects of cultivated, subconfluent, autologous keratinocytes in fibrin sealant (BioSeed®-S) on the healing of therapy-refractive chronic wounds. Patients and methods: Open observational study in 60 patients with chronic leg ulcers and impaired wound healing of various origins. After whole-skin excision and cultivation of the autologous keratinocytes, the suspended cells were applied to the preconditioned wound in fibrin sealant. Wound epithelization and wound size were recorded at defined times. Results: Fifty-two of the 60 participating patients could be evaluated. After 6 weeks, 29 ulcers (55.8%) were healed. The mean epithelization increased between the 8th and 42nd postoperative day from 23% to 62.5%. In 50.0% of the patients, global assessment of the wound showed a high degree of epithelization or healing after 42 days. In 32.6 % of treated patients, improvement was observed, while no healing tendency was to be found in 17.4%. Conclusion: The present observational study indicates that the transplantation of autologous keratinocytes suspended in fibrin sealant could be of advantage in the treatment of refractive leg ulcers.

Efficacy and Safety of a Hyaluronic Acid-Containing Gauze Pad in the Treatment of Chronic Venous or Mixed-Origin Leg Ulcers: A Prospective, Multicenter, Randomized Controlled Trial

2021 ◽  
Vol 66 (6) ◽  
pp. 147-157
Author(s):  
Jacek Mikosinski ◽  
Anna Di Landro ◽  
Krzysztofa Łuczak-Szymerska ◽  
Emilie Soriano ◽  
Carol Caverzasio ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Chronic Wounds ◽  
Treatment Time ◽  
Complete Healing ◽  
Leg Ulcers ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Multicenter Randomized Controlled Trial ◽  
Mixed Origin ◽  
Chronic Leg Ulcers

Introduction. Hyaluronic acid (HA)-containing formulations routinely are utilized along with standard therapy to promote faster healing of chronic wounds; evidence to guide clinical decisions on the use of topical HA in the healing of vascular leg ulcers is limited. Objective. This study compared the efficacy and safety of an HA-impregnated gauze pad with an identical gauze pad without HA in the treatment of chronic leg ulcers of vascular origin. Materials and Methods. A prospective, multicenter, multinational, parallel-group, randomized, double-blind, clinical study was conducted between June 13, 2017, and December 31, 2018. Adults with 1 or more chronic leg ulcers of venous or mixed origin between 2 months and 4 years’ duration were eligible to participate. Participants were randomized to treatment consisting of standard care (ie, ulcer cleansing, debridement/anesthesia as necessary, and optimized compression) and either application of a gauze pad containing 0.05% HA or a neutral comparator once daily for a maximum of 20 weeks. The primary efficacy endpoint was complete ulcer healing (100% reepithelialization of the wound area centrally assessed by 1 independent and experienced assessor blinded with respect to the treatment applied, as shown on digital photographs taken under standardized conditions at or before 20 weeks and confirmed 3 weeks later). Secondary efficacy endpoints included the percentage of completely healed target ulcers, residual area of target ulcer relative to baseline, the condition of the periulcerous skin, the total amount of analgesics used, the incidence of infection at the ulcer site of the target ulcer, patient adherence to treatment, time to achieve complete healing as centrally assessed, and pain intensity as measured by a visual analog scale. Results. Among the 168 participants (82 in the HA gauze pad group and 86 in the neutral gauze pad group), 33 (39.8%) in the HA group experienced complete healing of the target ulcer, which was significantly higher than the neutral comparator group (15, 18.5%; P = .002). Results in the full analysis and per-protocol sets were consistent with the primary results; no significant difference was noted in outcomes when participants’ wounds were stratified according to baseline ulcer size. Conclusions. HA delivered in a gauze pad formulation could be a beneficial treatment for chronic leg ulcers of venous or mixed origin.

A guide to cost-effective management of leg ulcers

2021 ◽  
Vol 27 (5) ◽  
pp. 136-144
Author(s):  
Matthew Taylor ◽  
Leanne Atkin
Keyword(s):  
Chronic Wounds ◽  
Adult Population ◽  
Cost Effective ◽  
Health Impact ◽  
Leg Ulcers ◽  
Evidence Based Practices ◽  
Obesity And Diabetes ◽  
Prevalence Of Obesity ◽  
The Cost

Chronic wounds have a substantial economic impact on the NHS, with leg ulcers alone costing almost £4.6 billion per year. Approximately 2% of the adult population is affected by lower limb ulceration, and this is rising as a result of demographics, including longer life expectancy and the increasing prevalence of obesity and diabetes. Even after healing, the recurrence rate of leg ulcers is high, meaning that the cost and health impact is a long-term problem. There appears to be a large variation in treatment methods, possibly as a result of a lack of evidence-based practices. The variation in practice means that, in many areas, healing times are far from optimal, leading to increased costs and health burden for the patient. This article outlines a number of previously published recommendations, including the leg ulcer treatment pathway. The article also provides an overview of the considerations when undertaking an economic evaluation of pathways, and provides recommendations about the type of data that should be routinely collected in clinical trials.

scholarly journals Effect of autologous platelet-rich plasma in the promotion of healing of chronic ulcers

2017 ◽  
Vol 5 (1) ◽  
pp. 15 ◽  
Author(s):  
Mohamed M. Raslan ◽  
Nader M. Milad ◽  
Ahmed Abd AlAziz
Keyword(s):  
Platelet Rich Plasma ◽  
Case Series ◽  
Cost Effective ◽  
Complete Healing ◽  
Major Advance ◽  
Average Decrease ◽  
Chronic Ulcers ◽  
Autologous Platelet Rich Plasma ◽  
The Mean ◽  
Autologous Platelet

Background: Chronic ulcers are a big health problem worldwide. Having a great impact at personal, social and professional levels. The use of autologous Platelet Rich Plasma (PRP) is a major advance in the treatment of these ulcers as an easy and cost-effective method. Platelets provide numerous growth factors enhancing tissue healing. The aim of this study was to evaluate the safety and efficacy of autologous platelet-rich plasma as a treatment of chronic non-healing ulcers.Methods: Autologous PRP was prepared from whole blood by centrifugation and activated by 10% calcium chloride. Twenty-Four (24) patients with non-healing ulcers of different etiologies, whom they met our inclusion criteria, were treated with PRP injected every two weeks locally into their wounds until healing. The ulcer dimensions were measured every week. The follow-up period was 12 weeks after healing.Results: The mean age of the study population 41±21 years. Complete healing was achieved in all patients. The mean rate of healing (average decrease in ulcer dimensions) was 0.48 cm/week. The rate of healing was greater at the week following injection. The mean time for healing was 6.11 weeks.Conclusions: Author witnessed the useful effects of PRP application on enhancing wound healing. The results from our case series showed that PRP is a safe and effective treatment for the promotion of healing chronic ulcers. Further research and controlled, randomized prospective clinical trials on larger patient population are important to validate our results.

scholarly journals Effect of Electrical Stimulation on Chronic Leg Ulcer Size and Appearance

2003 ◽  
Vol 83 (1) ◽  
pp. 17-28 ◽  
Author(s):  
Pamela E Houghton ◽  
Cynthia B Kincaid ◽  
Marge Lovell ◽  
Karen E Campbell ◽  
David H Keast ◽  
...  
Keyword(s):  
Surface Area ◽  
Electrical Current ◽  
Leg Ulcers ◽  
Wound Surface ◽  
Initial Examination ◽  
Sham Treatment ◽  
Chronic Ulcers ◽  
Arterial Insufficiency ◽  
To Receive ◽  
Chronic Leg Ulcers

Abstract Background and Purpose. Electrical current has been recommended for use on chronic pressure ulcers; however, the ability of this modality to improve healing of other types of chronic ulcers is less well established. The purpose of this study was to examine the effect of high-voltage pulsed current (HVPC) on healing of chronic leg ulcers. Subjects. Twenty-seven people with 42 chronic leg ulcers participated in the study. Methods. The subjects were separated into subgroups according to primary etiology of the wound (diabetes, arterial insufficiency, venous insufficiency) and then randomly assigned to receive either HVPC (100 microseconds, 150 V, 100 Hz) or a sham treatment for 45 minutes, 3 times weekly, for 4 weeks. Wound surface area and wound appearance assessed during an initial examination, following a 1- to 2-week period during which subjects received only conventional wound therapy, after 4 weeks of sham or HVPC treatment, and at 1 month following treatments. Results The results indicated that HVPC applied to chronic leg ulcers reduced the wound surface area over the 4-week treatment period to approximately one half the initial wound size (mean decrease=44.3%, SD=8.8%, range=2.8%-100%), which was over 2 times greater than that observed in wounds treated with sham units (mean decrease=16.0%, SD=8.9%, range=-30.3%-83.7%). Discussion and Conclusion. The results of the study indicate that HVPC administered 3 times a week should be considered to accelerate wound closure of chronic leg ulcers.

Validation of a Screening Questionnaire for Chronic Leg Ulcers

2016 ◽  
Vol 15 (4) ◽  
pp. 320-324
Author(s):  
Kian Zarchi ◽  
Peter Theut Riis ◽  
Christine Graversgaard ◽  
Iben M. Miller ◽  
Michael Heidenheim ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Large Scale ◽  
Chronic Wounds ◽  
Population Based ◽  
University Hospital ◽  
Leg Ulcers ◽  
Screening Questionnaire ◽  
Item Questionnaire ◽  
Chronic Leg Ulcers

The use of a validated screening questionnaire to identify individuals with chronic leg ulcers allows large-scale population-based studies to be conducted that measure and monitor the prevalence of the disease. The aim of this study was to design and validate such a screening questionnaire to identify patients with chronic leg ulcers. A simple 3-item questionnaire was developed at the Department of Dermatology, University Hospital of Zealand, Denmark. In total, 90 patients attending the department’s outpatient clinic for dermatological diseases and chronic wounds were included in this study. All included participants completed the questionnaire and were subsequently examined by dermatologists. We found that the constructed 3-item questionnaire in this study had a sensitivity and specificity of 95% and 93% and a positive predictive value and negative predictive value of 78% and 95%, respectively. Moreover, we found that the use of the 3-item questionnaire, as compared with a single question, in which the participants were asked whether they currently have a leg ulcer, resulted in significantly higher positive predictive value (+11.6%, P = .035) and specificity (+5.6%, P = .046) of the diagnostic test. Future studies are merited to investigate the diagnostic accuracy of the questionnaire in other populations and settings.

scholarly journals Use of platelet concentrate gel in second-intention wound healing: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Vincenzo Davide Palumbo ◽  
Stefano Rizzuto ◽  
Giuseppe Damiano ◽  
Salvatore Fazzotta ◽  
Andrea Gottardo ◽  
...  
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Recovery Period ◽  
Cost Effective ◽  
Platelet Concentrate ◽  
Wound Healing Process ◽  
Cost Effective Treatment ◽  
Healing Wound

Abstract Background Wound healing is a complex and dynamic process. Healing of acute and chronic wounds can be impaired by patient factors (that is, comorbidities) and/or wound factors (that is, infection). Regenerative medicine products, such as autologous/homologous platelet-rich plasma gel, may speed up the healing process. Autologous/homologous platelet-rich plasma is an advanced wound therapy used for hard-to-heal acute and chronic wounds. The cytokines and growth factors contained in platelet-rich plasma play a crucial role in the healing process. Case presentation A 61-year-old Caucasian male patient, suffering from mental retardation following meningitis, with a transplanted kidney due to prior renal impairment, and under immunosuppressant therapy, was submitted to aneurysmectomy of his proximal left forearm arteriovenous fistula. A few days later, the patient came to our attention with substantial blood loss from the surgical site. The wound presented no signs of healing, and after fistula reparation and considering persistent infection of the surgical site (by methicillin-resistant Staphylococcus aureus), surgeons decided for second-intention healing. To favor healing, 10 mL homologous platelet concentrate gel was sequentially applied. After each application, wound was covered with nonadherent antiseptic dressing. After only seven applications of homologous platelet concentrate gel, wound completely recovered and no amputation was necessary. Conclusions Topical application of homologous platelet-rich plasma gel in healing wound shows beneficial results in wound size reduction and induces granulation tissue formation. Platelet-rich plasma could be a safe and cost-effective treatment for managing the cutaneous wound healing process to shorten the recovery period and thereby improve patient quality of life.

scholarly journals Clinical Antimicrobial Photodynamic Therapy: Phase II Studies in Chronic Wounds

2012 ◽  
Vol 10 (Suppl_2) ◽  
pp. S-80-S-83 ◽  
Author(s):  
Stan Brown
Keyword(s):  
Photodynamic Therapy ◽  
Chronic Wounds ◽  
In Vivo Studies ◽  
Antimicrobial Photodynamic Therapy ◽  
Leg Ulcers ◽  
Preclinical Research ◽  
Accelerate Wound Healing ◽  
Phase Ii Studies ◽  
Chronic Leg Ulcers

Microbiologically based diseases continue to pose serious global health problems. Effective alternative treatments that are not susceptible to resistance are sorely needed, and the killing of photosensitized bacteria through photodynamic therapy (PDT) may ultimately emerge as such an option. In preclinical research and early in vivo studies, PDT has demonstrated the ability to kill an assortment of microorganisms. Antimicrobial PDT has the potential to accelerate wound healing and prevent clinical infection, particularly in patients with chronic leg ulcers. Larger trials are needed to confirm its early promise and suggest its ultimate role in caring for chronic wounds.

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