Histological analysis of fat grafting with platelet‐rich plasma for diabetic foot ulcers—A randomised controlled trial

Nolan, Grant S; Smith, Oliver J.; Heavey, Susan; Jell, Gavin; Mosahebi, Afshin

doi:10.1111/iwj.13640

Cited by 19 publications

(9 citation statements)

References 54 publications

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“…An RCT further confirmed this dynamic between aaPRP and stem cells. Histological analyses demonstrated improved neovascularization and graft survival in DFU wounds, although these results are not accompanied by a shortened wound healing time 43 . The findings of this literature review have been summarized in Table 2.…”

Section: Current Evidence and Study Resultsmentioning

confidence: 85%

Efficacy of Activated Autologous Platelet-Rich Plasma in The Treatment of Diabetic Foot Ulcers: An Evidence-Based Brief Literature Review

Fibrini¹,

Hanafie²

2022

Biotech Res

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Diabetic foot ulcers (DFUs) present as a debilitating complication of diabetes which approximately affects 6.3% of the global population with significant mortality and morbidity consequences. While one-third of the total cost of diabetic care goes to DFU treatment, 20% patients have unresolved ulcers, while 40% experience recurrency within one year. To improve outcomes in DFU care, activated autologous platelet-rich plasma (aaPRP) is one of the adjuvant therapies proposed. Containing various bioactive proteins such as growth factors and cytokines, it possesses regenerative, antioxidative, anti-inflammatory, and antimicrobial qualities. Furthermore, its autologous nature, which also makes it a highly safe treatment modality, is also promising. In this review, we shortly discuss the pathogenesis of DFUs and how aaPRP may tackle the key players in DFU pathogenesis to improve wound healing outcomes. We also briefly describe its method of isolation and the current views on aaPRP from an authoritative source. Lastly, we summarize the existing evidence for the utilization of aaPRP in the treatment of DFUs.

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Section: Current Evidence and Study Resultsmentioning

confidence: 85%

Efficacy of Activated Autologous Platelet-Rich Plasma in The Treatment of Diabetic Foot Ulcers: An Evidence-Based Brief Literature Review

Fibrini¹,

Hanafie²

2022

Biotech Res

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“…We summarized the basic characteristics of the included studies, as shown in Table 1 . The included studies were published between 2005 and 2023, with five studies from Egypt ( 34 , 38 – 40 , 48 ), four from China ( 41 , 44 , 45 , 52 ), three each from India ( 32 , 37 , 50 ) and Iran ( 35 , 36 , 51 ), two from the United Kingdom ( 33 , 49 ), and one each from the United States ( 43 ), Pakistan ( 46 ), and Lithuania ( 42 ). The studies included seven different interventions: fat transplantation, fat transplantation +PRP, PRP, conventional therapy (standard care, saline dressing), hyperbaric oxygen therapy, stem cell transplantation, and stem cell transplantation +PRP.…”

Section: Resultsmentioning

confidence: 99%

Platelet-rich plasma for the treatment of diabetic foot ulcer: a systematic review

OuYang,

Tang,

Yang

et al. 2023

Front. Endocrinol.

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BackgroundWith the increasing incidence of diabetes, diabetic foot ulcer(DFU) has become one of the most common and serious complications in people with diabetes. DFU is associated with significant morbidity and mortality, and can also result in significant economic, social and public health burdens. Due to peripheral neuropathy, peripheral vascular disease, hyperglycemic environment, inflammatory disorders and other factors, the healing of DFU is impaired or delayed, resulting in the formation of diabetic chronic refractory ulcer. Because of these pathological abnormalities in DFU, it may be difficult to promote wound healing with conventional therapies or antibiotics, whereas platelet-rich plasma(PRP) can promote wound healing by releasing various bioactive molecules stored in platelets, making it more promising than traditional antibiotics. Therefore, the purpose of this systematic review is to summarize and analyze the efficacy of PRP in the treatment of DFU.MethodsA literature search was undertaken in PubMed, CNKI, EMB-ASE, the Cochrane Library, the WanFang Database and the WeiPu Database by computer. Included controlled studies evaluating the efficacy of PRP in the treatment of diabetic foot ulcers. The data extraction and assessment are on the basis of PRISMA.ResultsTwenty studies were evaluated, and nineteen measures for the evaluation of the efficacy of PRP in DFU treatment were introduced by eliminating relevant duplicate measures. The efficacy measures that were repeated in various studies mainly included the rate of complete ulcer healing, the percentage of ulcer area reduction, the time required for ulcer healing, wound complications (including infection rate, amputation rate, and degree of amputation), the rate of ulcer recurrence, and the cost and duration of hospitalization for DFU, as well as subsequent survival and quality of life scores. One of the most important indicators were healing rate, ulcer area reduction and healing time. The meta-analysis found that PRP was significantly improve the healing rate(OR = 4.37, 95% CI 3.02-6.33, P < 0.001) and shorten the healing time(MD = -3.21, 95% CI -3.83 to -2.59,P < 0.001)of patients with DFU when compared to the conventional treatment, but there was no significant difference in reducing the of ulcer area(MD = 5.67, 95% CI -0.77 to 12.11,P =0.08>0.05 ).ConclusionThe application of PRP to DFU can improve ulcer healing rate and shorten ulcer healing time, but more clinical data are needed to clarify some efficacy measures. At the same time, a standardized preparation process for PRP is essential.

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“…This study demonstrated that five of the patients achieved 100% wound healing (two from the fat only group, two from the fat/PRP group). This concluded the safety of fat grafts in diabetic foot patients however further studies on a greater group of patients need to be done to find out about the effectiveness of this therapy [17].…”

Section: Wounds and Scarsmentioning

confidence: 92%

Stem cells in plastic surgery and aesthetic medicine

Czop,

Jałowska

2023

pdia

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Stem cells (SCs) have multiple applications in today's medicine including aesthetic dermatology and plastic surgery. The purpose of this paper is to review some clinical use of mesenchymal SCs. The main focus was put on adipose tissuederived stem cells (ADSCs) as these cells are easy to harvest and because of their properties showed great potential in many studies, where they proved to accelerate wound healing, reduce scars, cause hair regrowth, or rejuvenate skin. Furthermore, when added to lipofilling procedures, such as breast augmentation they enhance fat graft survival and provide satisfying results. Currently, many different strategies for using SCs in treatments are developed with great efficacy, however, there are still many limitations and concerns regarding their clinical use.

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Histological analysis of fat grafting with platelet‐rich plasma for diabetic foot ulcers—A randomised controlled trial

Cited by 19 publications

References 54 publications

Efficacy of Activated Autologous Platelet-Rich Plasma in The Treatment of Diabetic Foot Ulcers: An Evidence-Based Brief Literature Review

Efficacy of Activated Autologous Platelet-Rich Plasma in The Treatment of Diabetic Foot Ulcers: An Evidence-Based Brief Literature Review

Platelet-rich plasma for the treatment of diabetic foot ulcer: a systematic review

Stem cells in plastic surgery and aesthetic medicine

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