The effects of autologous platelet rich plasma in Chronic non- healing ulcers

Abstract

Introduction: Chronic non healing ulcers are those which do not heal by 4-6 weeks .and are characterized by a long inflammatory phase that hinders regenerative wound healing. They are the major cause of chronic wounds occurring in 70% to 90% of leg ulcers cases. Chronic non healing ulcers include venous ulcers, pressure ulcers, traumatic ulcers and diabetic ulcers. Autologous platelet rich plasma (PRP) is a safe, simple and inexpensive procedure in the treatment of chronic non healing ulcers. Objectives: 1. To determine the efficacy of autologous PRP in the management of chronic non healing ulcers and the time taken for complete healing of chronic non healing ulcers. 2. To determine the duration and the rate of healing with the application of autologous platelet rich plasma. Methods: 63 Patients with complaints of long standing chronic non healing ulcers were included with the following inclusion and exclusion criteria attending OPDs or getting admitted in the Department of General Surgery, Victoria Hospitals and Bowring & Lady Curzon Hospitals, Bangalore during the period from November 2014 to August 2016. Sixty three non-healing ulcers of various etiologies were treated with autologous PRP at weekly intervals for a maximum of 6 sittings/weeks. At the end of 6 weeks, the reduction in size of the ulcers (area and volume) was assessed.Results: The mean age of the patients was 47.89 years (SD 14.09). Among 63 patients, 43 (68.3%) were males & 20 (31.7%) were females. The mean duration of healing of the ulcers was in 3.9 weeks (SD 1.06). The mean percentage improvement in the area & volume of the ulcer at 3rd week was 79.38% (SD 16.01) & 89.49% (SD 8.99). Similarly, at 6th week was 99.67% (SD 1.87) & 99.83% (SD 0.94) respectively.Conclusion: Chronic non healing ulcers are often difficult to heal because they lack the necessary growth factors to maintain the healing process. Conventional therapies do not provide satisfactory healing, since these treatments are not able to provide the necessary growth factors (PDGF, EGF, VGEF etc.) which are essential for the healing process. PRP is a safe, affordable, biocompatible and simple office based procedure for the treatment of non-healing ulcers.