Effectiveness of Platelet-Rich Plasma and Hyaluronic Acid for the Treatment and Care of Pressure Ulcers

Abstract

Platelet-rich growth factor (PRGF) is a natural source of growth factors (GF), while hyaluronic acid (HA) is a biopolymer present in the extracellular matrix of skin, cartilage, bone, and brain, among other tissues. Both are involved in the pathophysiological mechanisms underlying wound healing. The objective of this study was to evaluate the clinical efficacy (as measured by ulcer area) and safety (as measured by signs of infection) of PRGF and PRGF plus HA in the treatment of pressure ulcers (PUs). Patients (N = 100) with 124 Stage II-III PUs were randomized to a control group (n = 25 PUs) for standard care or to case groups for treatment with one (n = 34 PUs) or two (n = 25 PUs) doses of PRGF from their own peripheral blood, or two doses of PRGF plus HA (n = 40 PUs). All ulcers were followed up every 3 days for a 36-day period. At 36 days, a significant reduction in ulcer area (p ≤ .001) was observed in all treatment groups, with a mean reduction of more than 48.0% versus baseline. The greatest mean reduction (80.4% vs. baseline) was obtained with the PRGF plus HA regimen. Complete wound healing was observed in 32.0% of PUs treated with two doses of PRGF (p ≤ .002) and in 37.5% of those treated with two doses of PRGF plus HA (p ≤ .004). There were no signs of infection in any PUs during the 36-day follow-up period. The degree of wound healing was inversely correlated with the consumption of drugs such as statins and with the peripheral blood platelet levels of patients at baseline.

Platelet‐rich plasma for the treatment of diabetic foot ulcers: A meta‐analysis

“…If the secondary dressing is active (i.e., hyaluronic), its combination with the PRP gel creates a new biomaterial which can modify the kinetics of cytokine release or PRP biology . In fact, PRP combined with hyaluronic acid yielded better outcomes than PRP alone in pressure ulcers …”

Impact of the Different Preparation Methods to Obtain Autologous Non-Activated Platelet-Rich Plasma (A-PRP) and Activated Platelet-Rich Plasma (AA-PRP) in Plastic Surgery: Wound Healing and Hair Regrowth Evaluation

“…Another mechanism that induces wound healing is the acceleration of hyaluronic acid (HA) production [12]. HA is a biopolymer identified in the ECM of skin, cartilage, bone and brain, among other tissues [22]. It can hydrate and modulate the cellular microenvironment, while its cell surface receptor bindings induce cell-to-cell adhesions, cell-substrate adhesions, proliferation, and cell migrations.…”

The Conservative Management of Osteoarthritis — Hyaluronic Acid, Platelet Rich Plasma or the Combination?

“…Currently, no clinical studies support this basic research. There are reports, which claim excellent results of the HA+PRP association in Morton neuroma surgery [88] and in the healing of pressure ulcers and surgical wounds [89,90]. However, these findings need confirmation by controlled trials, because only one study [90] has assessed the superiority of the composite PRP/HA in the treatment of pressure ulcers, in comparison with HA or PRP, used alone.…”