Comparison of the Efficacy of Autologous Platelet-Rich Plasma and Saline Dressing in Healing of Diabetic Foot Ulcer- A Randomised Control Study

Abstract

Introduction: According to research by the World Health Organisation (WHO), there are 347 million diabetics worldwide, and by 2030, it will overtake smoking as the seventh leading cause of death and diabetic people have a lifetime risk of up to 25% for developing a foot ulcer. Many novel techniques are emerging to fasten wound healing, including cellular therapies using Platelet-Rich Plasma (PRP) and collagen-based dressings. Aim: To compare the efficacy between instillation of autologous PRP and conventional dressing using normal saline/povidone iodine in Diabetic Foot Ulcers (DFU). Materials and Methods: This randomised control clinical study was conducted in the Department of General Surgery at SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India. The duration of the study was 18 months, from April 2021- September 2022. A total of 174 DFU patients were included in the study, meeting inclusion and exclusion criteria’s. Patients were divided into case (n=87) and control group (n=87). For six weeks, the case group got autologous PRP, while the control groups regularly had standard dressings. Wound areas were measured using ruler scale weekly and percentage of healing was monitored for 12 weeks. The data were analysed with International Business Machines (IBM)- Statistical Package for Social Sciences (SPSS) version 21.0. Results: In a group of 87 each, 174 patients with chronic non healing DFUs were randomly assigned to the study group (PRP) or the control group (conventional dressing method) throughout the 9 months study. Age ranged from less than 40 years to more than 61 years in the present study of 174 patients, with the age group between 51 and 60 years having the highest percentage of patients (50.6%), followed by the age group over 61 years (23.6%). About 12 weeks after the treatment, it was discovered that, the case group had a 86% reduction in wound area of 86.51±15.71 mm, whereas, the control group had a 61% reduction in wound area of 65.47±30.18 mm and 65.1% of patients from the case group showed wound healing, while 42.7% of patients from the control group showed wound healing. These findings were found to be statistically significant (p-value <0.001). Conclusion: The use of PRP led to a higher rate of wound healing in less time when compared to traditional wound care in the therapy of chronic DFUs, as shown in the present study. For chronic DFUs, PRP was able to speed up healing, making it a potentially viable and promising treatment.

Keywords

• diabetes mellitus
• non-healing ulcer
• wound healing