A comparative study on effect of platelet rich plasma Vs conventional dressing in healing rate of chronic diabetic ulcers

Introduction and Aim: This study has been undertaken to evaluate efficacy of platelet rich plasma (PRP) dressing that is recently introduced with conventional dressing. We have tried to compare PRP dressing with conventional normal dressing in healing the wound. Materials and Methods: We conducted this study in 120 patients of chronic non healing diabetic foot ulcers who were treated over the period of three years. Number of cases (60 each) were studied for efficacy of applying autologous platelet rich plasma versus normal dressing for chronic non healing diabetic foot ulcers. At every week follow up, the ulcer was examined for granulation tissue, area and volume which was calculated using Vernier calipers and marked on a graph paper and photographs were taken. Wound healing was compared between PRP and normal dressing. Results: The incidence of male susceptibility was more (70%) than females (30%) in diabetic foot. Average rate of healing per week was found to be significantly better among the PRP group than normal dressing group. The ulcer showed significant reduction in size among the PRP group in comparison to the normal dressing group with a significant P value (0.001). Conclusion: In this study application of platelet rich plasma into chronic non-healing diabetic foot ulcers in comparison with conventional dressing has shown a significant reduction in the size of the ulcer, hospital stay and cost for the patient.

Phagocytic and oxidative burst activity of neutrophils in type 2 diabetic patients with foot ulcers

Introduction and Aim: Diabetic foot ulcers are common complications seen in diabetic patients. Treatment of this disabling foot sore remains a challenge to health care professionals. This study aimed at evaluating whether the neutrophils from type 2 diabetic patients with foot ulcers present an impairment of phagocytic index and impairment in respiratory burst. We also aimed at understanding whether the impairment in neutrophil phagocytic activity can be alleviated with short course of standard treatment regime for foot ulcers. Methodology: For this case-controled study, 43 participants with type 2 diabetes (18 with foot ulcers and 25 without foot ulcers) were prospectively recruited along with 18 healthy volunteers. Phagocytic activity of neutrophils and respiratory burst of neutrophils was assessed along with ESR, percentage neutrophil counts before and after 2 weeks of standard treatment for foot ulcers. Results: Neutrophils of type 2 diabetic patients (with and without foot ulcers ) showed lower levels of phagocytic index and lower percentage of respiratory burst on comparison with non-diabetic subjects. Furthermore, on receiving treatment for foot ulcers, a significant improvement in neutrophil phagocytic indices were observed, along with improvement in wound ulcer score. Conclusion: Phagocytic activity of the neutrophils is impaired in type 2 diabetics (with and without foot ulcers). Neutrophil phagocytic indices can be improved on glycemic control. Additionally, improvement in neutrophil phagocytic indices after short course treatment for foot ulcers can be useful markers to predict treatment efficacy and in prognosis of diabetic foot ulcers.