Efficacy of autologous platelet-rich plasma in the treatment of chronic nonhealing leg ulcers

Abstract

Aim: The aim was to evaluate the efficacy of platelet-rich plasma (PRP) in the treatment of chronic nonhealing ulcers.

Methods: A nonrandomized, uncontrolled study was performed on 24 patients with 33 nonhealing ulcers of various etiologies. All patients were treated with PRP at weekly intervals for a maximum of 6 treatments. At the end of the 6-week period, reduction in size of the ulcers (area and volume) was assessed.

Results: The mean age of the patients was 42.5 years [standard deviation (SD) 12.48]. Of 33 ulcers, there were 19 venous ulcers, 7 traumatic ulcers, 2 ulcers secondary to pyoderma gangrenosum, 2 diabetic ulcers, 2 trophic ulcers, and 1 vasculitic ulcer. The mean duration of healing of the ulcers was 5.6 weeks (SD 3.23). The mean percentage of reduction in area and volume of the ulcers was 91.7% (SD 18.4%) and 95% (SD 14%), respectively. About 100% resolution in the area was seen in 25 (76%) of the ulcers and 100% reduction in volume was seen in 24 (73%) of the ulcers at the end of the 6th treatment.

Conclusion: Conventional therapies do not provide satisfactory healing for chronic nonhealing ulcers as they are not able to provide the necessary growth factors (GFs) (platelet-derived GF, epidermal GF, vascular endothelial GF, etc.) which are essential for the healing process. PRP is a safe, affordable, biocompatible, and simple office-based procedure for the treatment of nonhealing ulcers.

Keywords

Leg ulcers / platelet-derived growth factor / platelet rich plasma

References

[1] Mekkes JR,Van Der Wal AC.Causes, investigation and treatment of leg ulceration..Br J Dermatol2003;148:388-401

[2] Anderson I.Aetiology, assessment and management of leg ulcers..Wound Essent2006;1:20-36

[3] Braund R,Medlicott NJ.The role of topical growth factors in chronic wounds..Curr Drug Deliv2007;4:195-204

[4] Bhanot S.Current applications of platelet gels in facial plastic surgery..Facial Plast Surg2002;18:27-33

[5] Vaishnavi C,Narayanan LL.Treatment of endodontically induced periapical lesions using hydroxyapatite, platelet-rich plasma, and a combination of both: an in vivo study..J Conserv Dent2011;14:140-6 PMCID:PMC3146105

[6] Sarvajnamurthy S,Budamakuntala L.Autologous platelet rich plasma in chronic venous ulcers: study of 17 cases..J Cutan Aesthet Surg2013;6:97-9 PMCID:PMC3764770

[7] Blume PA,Payne W,Lantis J.Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers: a multicenter randomized controlled trial..Diabetes Care2008;31:631-6

[8] Yuan T,Tang MJ,Zeng BF.Autologous platelet rich plasma enhances wound healing in chronic wounds..Wounds2009;21:280-5

[9] Knighton DR,Fiegel VD,Butler EL.Classifi and treatment of chronic nonhealing wounds. Successful treatment with autologous platelet-derived wound healing factors (PDWHF)..Ann Surg1986;204:322-30 PMCID:PMC1251286

[10] Kakudo N,Minakata T,Kusumoto K.Platelet-rich plasma promotes epithelialization and angiogenesis in a splitthickness skin graft donor site..Med Mol Morphol2011;44:233-6

[11] Sánchez AR,Kupp LI.Is platelet-rich plasma the perfect enhancement factor? A current review..Int J Oral Maxillofac Implants2003;18:93-103

[12] Marx RE.Platelet-rich plasma (PRP): what is PRP and what is not PRP?.Implant Dent2001;10:225-8

[13] Frykberg RG,Carman D,Borris-Hale C,Rappl LM.Chronic wounds treated with a physiologically relevant concentration of platelet-rich plasma gel: a prospective case series..Ostomy Wound Manage2010;56:36-44

[14] Steenvoorde P,Naves C.Use of autologous platelet-rich fibrin on hard-to-heal wounds..J Wound Care2008;17:60-3

[15] Kakudo N,Ogura N,Suzuki K.The use of autologous platelet rich plasma in the treatment of intractable skin ulcer..Open J Reg Med2012;1:29-32

[16] Dohan DM,Diss A,Dohan AJ,Gogly B.Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part III: leucocyte activation: a new feature for platelet concentrates?.Oral Surg Oral Med Oral Pathol Oral Radiol Endod2006;101:e51-5