Clinical Dermatology Review (Jan 2022)
A study of platelet-rich plasma in the management of chronic nonhealing ulcers
Abstract
Background: Chronic nonhealing ulcers run protracted course and require prolonged rest and complete avoidance of pressure, antibiotics, and antiseptic dressing, which at times may not yield satisfactory results. Local application of certain growth factors is known to promote healing in these cases. Objectives: To study the efficacy of autologous platelet-rich plasma in the management of chronic nonhealing ulcers. Materials and Methods: Z-statistics and Chi-square tests were used in the statistical analysis of this study. The study consisted of 30 patients of chronic nonhealing ulcers who presented to the dermatology department. Patients aged between 18 and 65 years of both sexes presenting with noninfective ulcer of duration of more than 6 weeks, treated or untreated and who have normal complete blood picture, were recruited. Diabetic patients with uncontrolled sugar levels were excluded. Ulcer examination was carried out as per clock-face method. Examination of peripheral pulses, nerves, and sensations was carried out. Routine hematological and biochemical investigations were done. Platelet-rich plasma was prepared from patient's blood, and 1.5–2 ml was injected at the healing margins using insulin syringe (26 G) after cleaning. Procedure was repeated once weekly for 6 weeks, and the ulcer healing was assessed. Results: Of the 30 cases, 21 (70%) were male and 9 (30%) were female, with a male-to-female ratio of 2.3:1. A maximum number of cases were in the fifth decade (33.3%). Trophic ulcers (TUs) due to leprosy contributed to 30 (88.23%), venous ulcers (VUs) 2 (5.88%), and diabetic ulcers 2 (5.88%). Improvement in area of TUs due to leprosy was 92.5%, in VUs 88.45%, and in diabetic ulcer 98.02% at the end of 6 weeks of platelet-rich plasma therapy. Conclusion: Platelet-rich plasma is an easily obtainable blood derivative and is a safe and potentially reasonable adjunct in the treatment of chronic nonhealing ulcers with advantage of no concern of immune reactions or cross-reactions or toxicity. It not only promotes healing but also prevents amputation necessitated by complications due to chronic ulcers.
Keywords
