Autologous Platelet-rich Plasma vs Conventional Dressing in the Management of Chronic Diabetic Foot Ulcers

Abstract

Introduction. Diabetic foot ulcers (DFUs) are a major complication of diabetes. Recently, considerable progress has been achieved in techniques that promote wound healing. Autologous platelet-rich plasma (PRP) is one such technique that is gaining popularity. Platelet-rich plasma is thought to stimulate wound healing by releasing growth factors essential for healing. Objective. This research aimed to study the efficacy of PRP in managing chronic DFUs. Materials and Methods. Seventy-two patients with chronic DFUs were equally divided into 2 groups. The first group was treated with activated PRP injection and gel on the surface of the ulcer, and the second group was treated with conventional dressing using normal saline to irrigate the wound, followed by coverage with petrolatum gauze and sterile dressing. Results. Both methods of treatment improved healing, but there was a significant increase in healing rate among the PRP group compared with the conventional dressing group (31/36 patients [86.11%] vs 23/36 patients [63.89%]; P =.029). Additionally, the healing duration was shorter in the PRP group than in the conventional dressing group (10.90 weeks ± 3.40 standard deviation vs 13.48 weeks ± 3.37, respectively; P =.01). Conclusions. The use of autologous PRP results in a higher rate of wound healing in less time compared with conventional wound care in managing DFUs. Platelet-rich plasma is an effective and promising treatment for chronic DFUs; PRP enables healing in less time. This is expected to positively affect the individual’s performance and minimize long-term health care expenditure on foot ulcers.

Comparative efficacy of growth factor therapy in healing diabetes‐related foot ulcers: A network meta‐analysis of randomized controlled trials

“…Overall in these 13 trials, 85.4% had neuropathic ulcers and 14.6% had ischaemic ulcers (Table 2). Twenty‐eight trials reported the ulcer duration 15,16,18,20,22–24,30–42,44–48,50–52 and 29 trials reported ulcer size at the start of the study 15,16,18,20,22–24,29–40,42–48,50–52 (Table 2). None of the included trials with mixed aetiology DFU reported complete wound healing of neuropathic and ischaemic ulcers separately.…”

“…Overall 11 trials had a low risk of bias, 15,20,23,32,33,36,39,43,47,48,52 9 had some concerns, 18,29,35,37,40,41,45,50,51 and 11 had a high risk of bias 16,22,24,30,31,34,38,42,44,46,49 (Table 3). In the randomisation process, 22 trials had a low risk of bias 15,16,18,20,23,29,30,32–34,36–39,43,45–48,50,52,53 and 9 had some concerns 22,24,31,35,41,42,44,49,51 . Thirteen trials had a low risk of bias, 15,16,20,22,23,32,33,36,39,43,47,48,52 15 had some concerns 18,24,29–31,34,35,37,41,42,44,45,50,51,53 and 3 had a high risk of bias 38,46,49 in deviation from the intended intervention.…”

The Efficiency and Safety of Platelet-Rich Plasma Dressing in the Treatment of Chronic Wounds: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Nowadays, PRP has been applied in clinical trials and is supposed to be a potential treatment for chronic wound treatment. Among these studies, there were two routes of PRP administration found: one constituted injecting PRP around the wound, and the other one constituted wrapping the wound with PRP dressing [ 60 ]. Because of the high risk of subcutaneous injection and the pain of injection, most studies focused on the clinical healing rate and complications of PRP dressings in treating chronic wounds.…”

Translational development of ABCB5+ dermal mesenchymal stem cells for therapeutic induction of angiogenesis in non-healing diabetic foot ulcers

“…A variety of other cell-based treatment strategies have been tested in controlled clinical trials for adjunctive treatment of DFUs, including autologous and allogeneic MSCs derived from bone marrow and adipose tissue [80][81][82], autologous adipose tissue and adipose-derived stromal vascular fraction cells [83,84], autologous platelet-rich plasma [83,[85][86][87][88][89][90], allogeneic platelets [91], autologous skin cells [92], skin allografts [93], and various cell-containing skin substitute products [94][95][96][97][98][99] (for a summary see Additional file 1: Table S15). The reported effects show great variations, ranging from wound surface area reductions and full wound closure ratios within 12-26 weeks that did not significantly differ from the control groups [82,83,85,92] to impressive significant wound surface area reductions from baseline of up to 98% within 80 days [90] and wound closure ratios of up to 100% within 8 weeks [84].…”