Randomized Controlled Trial on Autologous Platelet‐Rich Plasma Versus Saline Dressing in Treatment of Non‐healing Diabetic Foot Ulcers

Abstract

Background This randomized clinical trial was conducted to assess the role of platelet-rich plasma (PRP) gel as a treatment of clean non-healing diabetic foot ulcer (DFU) in comparison with regular dressing with saline as a control. Methods Patients with DFU were randomly assigned to one of two equal groups: group I received dressing with PRP gel and group II received regular saline dressing. The main outcomes of the study were percent reduction in the dimensions of the DFU, healing of DFU, and complications at 20 weeks of follow-up. Results Twenty-four patients were included to the study. The mean age of patients was 55.2 ± 6.4 years. Only three (25%) patients in group I achieved complete healing versus none of group II patients. In total, 8.3% of group I and 41.6% of group II patients did not show any response to treatment. The percent of reduction in the longitudinal and horizontal dimensions of the DFU was significantly greater in group I than group II (43.2% vs 4.1%) and (42.3% vs 8.2%), respectively. The time required to maximum healing was significantly shorter in group I than group II (6.3 ± 2.1 vs 10.4 ± 1.7 weeks, P \ 0.0001). Conclusion The use of PRP gel as a dressing for chronic DFU resulted in a more significant reduction in the size of the ulcer when compared to regular saline dressing. Also the time to reach the point of maximal possible healing with the least wound dimensions was significantly shorter when using PRP as a dressing protocol.Ahmed Elsaid and Mohammed El-Said contributed equally to the study and both are considered co-first Author.

Efficacy of autologous platelet-rich plasma gel in the treatment of refractory pressure injuries and its effect on wound healing time and patient quality of life

“…Refractory pressure injuries are mainly characterized by persistent symptoms and severe wound infections; these characteristics are related to blocked microcirculation, reduced local blood flow, attenuated phagocytosis, accelerated destruction of tissue proteins, and wound infection. Therefore, improving cell migration in scaffolds, activating cell proliferative activity, and reducing wound inflammatory responses are key parameters involved in the acceleration of wound repair (10,11). NPWT is a common method to treat refractory pressure injuries and has the following advantages: it insulates the wound and avoids secondary infection; promotes the exudation of wounded and necrotic tissue from the body, and increases blood flow in the wound and accelerates the growth of granulation tissue through negative pressure stimulation.…”

Platelet-rich plasma accelerates skin wound healing by promoting re-epithelialization

“…In addition, PRP is used in the clinical treatment of acute and chronic wounds in an unconventional manner with good results. PRP can increase the healing rate of diabetic wounds, reduce the injury area of pressure ulcers and improve joint function in osteoarthritis (OA) [ 10–12 ].…”

Current applications of platelet gels in wound healing—A review

“…All the above studies were summarized in Table 4. [78][79][80][81][82][83][84][85] Furthermore, there are more studies to evaluate the efficacy and safety of PG for patients with diabetic ulcers, one study with 15 RCTs with 829 patients, 77 another study with 8 RCTs involved 431 participants. 86 These evidences suggested that PG was effective and safe, and feasible for diabetic ulcers.…”

“…Both studies suggested that the application of PG was an efficient and safe treatment option, for the treatment of oral cGvHD patients who do not respond to standard local treatment.PRP is a simple, low-cost, safe, minimally invasive, and effective technique in clinical trials on DFU, researches include randomized controlled trial (RCT), meta-analysis, and system review. Elsaid et al78 conducted an RCT with 24 patients to assess PG as a treatment of clean non-healing DFU in comparison with regular dressing with saline as a control. Results showed that compared to regular saline dressing, PG as a dressing for chronic DFU resulted in a more significant reduction in the size of the ulcer and the time to reach the point of maximal possible healing was shorter.…”