Context: Diabetic foot ulcer (DFU) remains a devastating and prevalent complication of diabetes, which leads to significant morbidity, mortality, and economic implications. Outcomes of DFU management are still unsatisfactory, warranting innovations to improve them. One accessible and promising potential for treating DFU is autologous platelet-rich plasma (PRP), a blood product abundant in bioactive molecules. Platelet-rich plasma has been used in other fields of medicine to treat various conditions. Evidence Acquisition: While there is substantial research studying the use of PRP for DFU, these studies are regarded as having flaws in methodology. Hence, this systematic review aims to bridge the knowledge gap by only including randomized controlled trials (RCT). Results: After sifting through various databases, six studies were included. This review focused on specific outcomes, namely percentage of patients with healed wounds, wound size, and time to closure. Conclusions: The authors found that PRP has performed well with regards to healing DFU wounds with a high rate of healing, which leads to a shorter time to wound closure.

Context: Autologous activated platelet-rich plasma (aaPRP) is a platelet-based therapy with high concentrations of growth factors that enhance the process of wound healing and glucose normalization. Aims: To evaluate the safety and efficacy of systemic and local administration of autologous activated platelet-rich plasma in diabetic foot ulcer wound healing and patients’ serum hemoglobin A1C. Methods: Ten subjects were equally randomized to placebo and aaPRP treatment. The aaPRP was administered locally and intravenously. Wound surface area and serum HbA1c levels were recorded on days 0, 7, and 14. Results: Injection of aaPRP for two weeks shows better clinical outcomes in reducing wound surface area non-significantly (40.11 ± 43.22 vs. -8.29 ± 49%; p = 0.136) and serum HbA1c levels non-significantly compared to the control group (2.16 ± 0.54 vs. 1.64 ± 2.218%; p = 0.635). However, patients in the aaPRP group had significantly better control of HbA1c within the first week of treatment (1.39 ± 0.84 vs. -0.08 ± 0.92; p = 0.030). Conclusions: aaPRP could be considered a potential therapeutic strategy in patients with diabetic foot ulcers.

Background: In this cross-sectional study, we investigated three diabetic foot ulcer (DFU) patients. DFU is a serious diabetes complication affecting general health and social life. Autologous regenerative therapies, such as autologous activated platelet-rich plasma (aaPRP), have been proposed for DFU management. However, precise instruments are required to measure the wound size to evaluate wound closure after treatment. Objectives: This study aimed to evaluate the DFU healing process treated by aaPRP through digital image analysis using ImageJ software (National Institute of Health, USA). Methods: The DFU patients were administered aaPRP and followed up on days 7 and 14. The healing process was analyzed through ImageJ software. Paired t-test was used to assess the wound healing process. Results: The results showed that ImageJ was useful for wound area measurement. Granulation and sloughy tissue development can be evaluated and calculated as a part of wound healing progress. Conclusions: We conclude that ImageJ facilitates DFU analysis not only about the size but also on the healing time process through visualization of granulation and sloughy tissue formation, which can represent the healing progress.