Autologous platelet‐rich plasma for healing chronic venous leg ulcers: Clinical efficacy and potential mechanisms

Abstract

The overall quality of evidence of autologous platelet‐rich plasma (PRP) for treating chronic wounds remains low. While further well‐designed clinical studies are clearly required to convincingly demonstrate the efficacy of autologous PRP in improved healing of venous leg ulcers (VLUs) and other chronic wounds, there is also an increasing need to better define the underlying mechanisms of action and whether positive outcomes can be predicted based on the analysis of PRP. This brief review will discuss the current understanding of autologous PRP in VLUs and whether molecular evaluation of PRP at the time of collection could potentially be informative to clinical outcomes. Benefits of the autologous PRP treatment strategy include that PRP is easily accessible and is relatively inexpensive and safe. Better understanding of the mechanisms involved could improve treatment, enable supplementation, and/or lead to gains in product development. Analysis of PRP could also add value to future clinical trials on efficacy and potentially personalised treatment regimens.

Functional Biomaterials for Treatment of Chronic Wound

“…There are clinical treatments for these complications, including systemic application of antibiotics, frequent changing of dressings, operative debridement, and flap repair. Other therapeutic techniques include the application of hyperbaric oxygen therapy (HBOT) to improve the wound microenvironment by increasing local oxygen content, the use of negative pressure-assisted wound therapy (RNPT) to improve the local blood supply, and the use of platelet-rich plasma (PRP) that is rich in cytokines and nutritional factors to treat chronic wounds (O'reilly et al, 2011;Topaz, 2012;Powers et al, 2016;Weller et al, 2019). However, the conventional treatment methods have the several disadvantages, including the need for anesthesia in patients undergoing operative debridement, the side effects of systemic application of antibiotics, and the repair of chronic wounds caused by flaps and skin grafts.…”

Updates on Recent Clinical Assessment of Commercial Chronic Wound Care Products

“…These include hyperbaric oxygen therapy (HBOT) for augmenting the local oxygen level of the wound bed, negative pressure-assisted wound therapy (NPWT) for improving the local supply of blood, and interventions with plateletrich plasma (PRP), which is rich in growth and can effectively improve wound healing process. [18,41] However, such conventional approaches have various disadvantages in chronic wound treatment, including i) the usage of anesthesia in patients going through operational debridement, ii) prolonged and heavy doses of antibiotics and a possibility of antibiotic resistance, iii) lack of granulation tissue formation in a frail population even after SOC and adjuvant therapies. [42] Several phase I, II, III, and IV clinical trials have been performed in the past years using wound care products.…”

Modern technologies of venous ulcers treatment in elderly population

“…Активированные тромбоциты в фибриновой матрице высвобождают содержимое гранул, включая факторы роста, необходимые для заживления раны: тромбоцитарный фактор роста (PDGF), трансформирующий фактор роста β (TGF-β), эпидермальный фактор роста (EGF) и фактор роста эндотелия сосудов (VEGF) [30]. При ВТЯ в сосудистой сети кожи тромбоциты играют ключевую роль в стимуляции факторов роста для запуска процесса регенерации тканей, включая взаимодействие между рецепторами тромбоцитов, гликопротеином (GP) VI и C-типа лектин-подобного рецептора 2 (CLEC-2) с внесосудистым коллагеном и подпланином на макрофагах [29,31]. В 2018 г. группа исследователей под руководством H.A.…”