A case report on the use of sustained release platelet-rich plasma for the treatment of chronic pressure ulcers

Abstract

Background/objectives: Chronic pressure ulcers affect patient health, emotional state, and quality of life, causing considerable morbidity and mortality in addition to contributing to significant health care costs from lengthy hospitalizations to advanced home care and surgical care costs. The conventional treatment of these wounds can be slow due to their chronic inflammatory state and the senescence of local reparative cells. Platelet-rich plasma (PRP) therapy has been growing as a viable treatment alternative for a number of clinical applications and has potential benefit for use in chronic wounds. The sustained release of large quantities of autologous growth factors, cytokines, and other mediators found in PRP plus the favorable mononuclear cell profile of PRP may help us to stimulate wound healing and resolve chronic inflammation. Methods: Three veterans with spinal cord injury (SCI), presenting with chronic stage IV pressure ulcers, were treated with a sustained release PRP therapy to stimulate wound healing. Results: PRP treatment consistently resulted in the formation of granulation tissue and improved vascularity for each of the three patients treated, while reducing the overall ulcer area and volume. Conclusion: The controlled release of growth factors from PRP demonstrated a positive stimulatory effect on the healing rate of chronic pressure ulcers in individuals with SCI.

Using Electrospun Scaffolds to Promote Macrophage Phenotypic Modulation and Support Wound Healing

“…Infiltration of cells can only occur when the scaffold pores are of adequate size. Another factor in pore size is the allowance of multiple cells per pore to create blood vessels that will provide nutrients and further monocyte infiltration to the area, which will induce a more complete wound healing [46]. In addition to this, previous literature has supported that cell penetration and ECM deposition both increase with increasing fiber thickness; where smaller fibers can obstruct infiltration [47][48][49].…”

“…Higher fiber stiffness promotes cell attachment and proliferation, while an intermediate stiffness supports cell migration [50]. With the inclusion of a chemotactic dopant such as PRGF, infiltration can be enhanced, potentially lessening the healing time of the chronic wound; PRGF has been shown to signif- icantly reduce healing time in a chronic ulcer model when encapsulated within hydrogels [46].…”

“…The PRP stimulated angiogenesis and healing and promoted closure in all ulcers treated, but with significant scar formation. Healed but scarred ulcers indicate that while the growth factors and cytokines in PRP can accelerate wound closure, a scaffold is necessary to provide structure, support, and to prevent scarring and subsequent wound re-opening [29].…”

“…Platelet-rich plasma (PRP), has been previously used with some success to treat chronic dermal wounds [28][29][30]. Recent research has indicated that lyophilized PRP (i.e.…”

Platelet-rich plasma for the treatment of chronic wounds: evidence to date

“…The outcomes of the isolated cases and small series published are often spectacular. [28][29][30] These reports show noteworthy variability in the size and etiology of the lesions, as well as the method for obtaining and applying PRP. Wound etiologies that have been treated with PRP include diabetic, pressure, or venous ulcer, surgical or traumatic wounds, and wounds of other etiologies.…”