Platelet-rich plasma, bilayered acellular matrix grafting and negative pressure wound therapy in diabetic foot infection

Deng, Wuquan; Boey, Johnson; Chen, B.; Byun, Soo-Hwan; Lew, Eric; Liang, Ziwen; Armstrong, David G.

doi:10.12968/jowc.2016.25.7.393

Cited by 28 publications

(24 citation statements)

References 23 publications

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“…87 In another study, PRP gel was found to be superior to antiseptic ointment dressing. 88 Similar positive effects on accelerating the healing of infected wounds has also been demonstrated in clinical trials, 89,90 even showing efficacy in patients with severe arterial disease. 91…”

Section: Treatment For Chronic Ulcersmentioning

confidence: 62%

Platelet-Rich Plasma for the Treatment of Tissue Infection: Preparation and Clinical Evaluation

Zhang

Guo

Kuss

et al. 2019

Tissue Engineering Part B: Reviews

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The management and treatment of tissue infection, especially chronic infection, represents a significant challenge. Application of autologous platelet-rich plasma (PRP) has emerged as a promising adjunct therapy for facilitating the healing of surgical wounds and tissue injuries. PRP is extracted from whole blood using a sequential centrifugation technique and when activated, can release a vast array of antimicrobial proteins, cytokines, and growth factors. These bioactive molecules are responsible for the ability of PRP to kill pathogens, resolve necrotic tissue, and promote wound healing. PRP is emerging as a useful supplement to prevent postoperative infection and treat chronic wound or bone infections. PRP displays a synergistic effect with antibiotics, which provides unique advantages when treating antibiotic-resistant bacteria. This review will describe the method for PRP preparation and its antibacterial properties, as well as discuss both preclinical in vivo results and evidence from clinical practice of PRP use for the treatment of wound and bone infections.

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Section: Treatment For Chronic Ulcersmentioning

confidence: 62%

Platelet-Rich Plasma for the Treatment of Tissue Infection: Preparation and Clinical Evaluation

Zhang

Guo

Kuss

et al. 2019

Tissue Engineering Part B: Reviews

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“…Combined with the application of NPWT, bilayered acellular matrix grafting, and split-thickness skin grafting, APG shows obvious effectiveness in foot necrotizing fasciitis and gaseous gangrene. 10 NPWT could facilitate wound healing by promoting tissue perfusion and providing a moist local environment for wound coverage. 31,32 Additionally, wound healing is not the ultimate goal of DFU management.…”

Section: Discussionmentioning

confidence: 99%

“…The exposed bone had been successfully closed although there was no significant reduction in the size of ulceration ( Figure 1C). After full evaluation and informed consent was obtained, autologous platelet-rich gel (APG) was prepared as described in our previous study 10 (Figure 2A) and the gel was administered to the surface of the wound ( Figure 2B). After 10 days, granulation tissues gradually grew in the ulcer cavity.…”

Section: Case Reportmentioning

confidence: 99%

<p>Limb Salvage and Prevention of Ulcer Recurrence in a Chronic Refractory Diabetic Foot Osteomyelitis</p>

Jiang

et al. 2020

DMSO

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Biomechanical changes caused by structural foot deformities predispose patients to plantar ulceration. Plantar ulcer recurrence often leads to osteomyelitis, which is more commonly observed in patients with diabetes. Once the infection of diabetic foot ulcer (DFU) spreads and is complicated by osteomyelitis, treatment becomes more complicated and difficult. Osteomyelitis treatment remains challenging because of low drug concentration within the tissue caused by poor circulation and inadequate localized nutrition. Moreover, tissues around plantar ulcers are fewer and are thin, making the formation of granulation tissues difficult due to elevated plantar pressure. Furthermore, the skin around the wound is excessively keratinized, and the epidermis is hard to regenerate. Meanwhile, skin grafting at that site is often not successful due to poor blood circulation. Therefore, it is technically challenging to manage diabetic pressure plantar ulcer with osteomyelitis and prevent its recurrence. Here, we present a case of chronic DFU complicated by osteomyelitis due to foot deformity. The ulcer was successfully healed using advanced wound repair technology comprising of surgical bone resection, vancomycin-loaded bone cement implant, negativepressure wound therapy, and autologous platelet-rich gel. Subsequently, preventive foot care with custom-made offloading footwear was prescribed. The plantar ulcer did not recur and improvement in biomechanical parameters was observed after the intervention. This case represents an effective and comprehensive management strategy for limb salvage and prevention in patients with complicated foot conditions.

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“…The causes of chronic skin wounds include a complex combination of local and systemic factors, such as circulatory dysfunction, infection, wound duration, malnutrition, endocrine‐metabolic disturbances, aging, and immunodeficiency . Although multidisciplinary treatments are necessary for chronic wounds and various methods of treatment have been employed for years, some cases remain refractory to existing treatments, and the wound healing processes do not progress for unclear reasons …”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4] Although multidisciplinary treatments are necessary for chronic wounds and various methods of treatment have been employed for years, some cases remain refractory to existing treatments, and the wound healing processes do not progress for unclear reasons. [5][6][7][8][9] Hochu-ekki-to (HET; Bu-Zhong-Yi-Qi-Tang in Chinese) is a traditional Japanese herbal medicine that originated in China and is commonly used to treat severe weakness, loss of appetite, and indigestion in elderly patients and to prevent opportunistic infections in infection-prone patients. [10][11][12][13][14] Basic research has reported improvement of leukopenia, IgE antibody production and inhibitory action, antiviral action via activation of natural killer T cells, and protective action against bacterial infection with the use of HET.…”

Section: Introductionmentioning

confidence: 99%

The beneficial effect of traditional Japanese herbal (Kampo) medicine, Hochu‐ekki‐to (Bu‐Zhong‐Yi‐Qi‐Tang), for patients with chronic wounds refractory to conventional therapies: A prospective, randomized trial

Akita

Namiki

Kawasaki

et al. 2019

Wound Repair Regeneration

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Hochu‐ekki‐to (HET) is a traditional Japanese herbal (Kampo) medicine for the treatment of severe weakness, loss of appetite, and indigestion in elderly patients and for the prevention of opportunistic infections. The impact of HET on patients with chronic wounds refractory to conventional therapies was investigated in a prospective, randomized trial, including 18 patients divided into medication (7.5 g oral HET per day, n = 9) and control (n = 9) groups. Wound healing during the 12‐week study period was scored based on depth, exudate, size, inflammation/infection, granulation tissue, necrotic tissue, and pocket size. At 12 weeks, wound healing progressed in all nine patients in the medication group, whereas wound healing progressed in only three patients in the control group (significant difference, p < 0.01; relative risk: 3.00). In the medication group, the total score decreased significantly at 8 weeks and later. To the best of our knowledge, this study was the first to show that HET promoted the healing of chronic wounds resistant to conventional treatments. HET may be a choice as an adjunctive therapy for chronic wounds, particularly for patients with malnutrition. This trial was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000031620).

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Platelet-rich plasma, bilayered acellular matrix grafting and negative pressure wound therapy in diabetic foot infection

Abstract: The authors have received no financial support for the material presented in this study outside of the scope of standard patient care reimbursement. This work was supported by the National Natural Science Foundation of China (NO. 81500596) awarded to Dr Wuquan Deng.

Cited by 28 publications

References 23 publications

Platelet-Rich Plasma for the Treatment of Tissue Infection: Preparation and Clinical Evaluation

Platelet-Rich Plasma for the Treatment of Tissue Infection: Preparation and Clinical Evaluation

<p>Limb Salvage and Prevention of Ulcer Recurrence in a Chronic Refractory Diabetic Foot Osteomyelitis</p>

The beneficial effect of traditional Japanese herbal (Kampo) medicine, Hochu‐ekki‐to (Bu‐Zhong‐Yi‐Qi‐Tang), for patients with chronic wounds refractory to conventional therapies: A prospective, randomized trial

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