Role of local application of autologous platelet-rich plasma in the management of pressure ulcers in spinal cord injury patients

Abstract

Study design: Prospective clinical case series. Objectives: The objective of this study is to evaluate the local application of platelet-rich plasma (PRP) in relation to pressure ulcers (PrUs) healing on one PrU (case) versus saline dressing on another PrU (control) in the same patient. Setting: Tertiary Level Care Centre, India. Methods: Twenty-five spinal cord injury patients with at least two PrUs were included. All 25 PrUs (case) were grade IV, and PrUs (control) were grade II (n ¼ 11), grade IV (n ¼ 10) and grade III in 4 patients. Evaluation of PrU healing was done by measuring wound surface area, Pressure Ulcer Scale for Healing (PUSH), biopsy and clinical examination. Results: Statistically significant decrease in mean PUSH scores of PrUs (case) (t ¼ 6.13, Po0.000) and PrUs (control) (t ¼ 3.98, P ¼ 0.000) was observed after 5 weeks. The wound surface area of PrU (case) decreased significantly (t ¼ 4.98, P ¼ 0.000); however, the decrease was not significant (t ¼ 0.095, P ¼ 0.924) in PrUs (control). Majority of histopathological pictures of PrUs (case) showed necrosis and suppuration (56%) at the time of enrollment and well-formed granulation tissue and epithelialization (60%) at the 5th week. Twenty-four (96%) PrUs (case) improved and only 1 deteriorated with PRP therapy, whereas in control group 17 (68%) PrUs improved, 7 (28%) deteriorated and 1 wound showed no change. Conclusions: Advanced wound therapy using local applications of PRP seems to be a promising alternative to standard saline dressings in PrU healing. With the advantages of simple preparation, biocompatible safety, low cost and significant clinical effectiveness, it may be beneficial to study the effects of PRP in large-scale trials to validate it as an ideal therapy for enhanced wound healing in PrUs.

To Evaluate Antimicrobial Properties of Platelet Rich Plasma and Source of Colonization in Pressure Ulcers in Spinal Injury Patients

“…2nd week antimicrobial properties can decrease colonization and hence infection rate. In the another study, we have demonstrated that advanced wound therapy using local application of PRP seems to be a promising alternative to standard saline dressing in PrU healing [27]. No major complication was observed with local PRP therapy.…”

“…Yuan et al showed no adverse effect with PRP treatment in 3 patients with chronic wounds [1]. Singh et al reported no systemic or wound site side effect after PRP treatment in 49 patients [27].…”

Comparison of platelet‐rich plasma gel in the care of the pressure ulcers with the dressing with serum physiology in terms of healing process and dressing costs

“…Moreover, an increase in area size, worsening of tissue healing and decrease in exudate amount were determined. Singh et al performed an experimental study in 2014 with 25 patients and applied SP and PRP to pressure sores . In this study, it was reported that ulcer healing was faster in patients with PRP dressing than patients with SP dressing .…”

“…Singh et al performed an experimental study in 2014 with 25 patients and applied SP and PRP to pressure sores . In this study, it was reported that ulcer healing was faster in patients with PRP dressing than patients with SP dressing . In a study conducted by Mazzukko, it was found that almost all of the chronic ulcerss healed after PRP gel wound care compared to ulcer care with SP .…”

Platelet-derived bio-products: Classification update, applications, concerns and new perspectives

“…The main uses of PRP in ophthalmology are dry eye, graft-versus-host disease, persistent epithelial defects, corneal ulcers or perforations, burns and post-LASIK syndrome (27,(48)(49)(50). The regenerative potential of platelet-rich products has also been tested in tympanic perforation (51,52), skin lesions (53) -such as skin ulcers of multifactorial etiology: diabetic foot (54-56), pressure ulcers (57,58), venous ulcers (59) and even leprosy ulcers (60)-, vitiligo (61) and androgenetic alopecia (62). In the area of gynecology there are reports of the use of PRP to aid wound healing and recovery in caesarean delivery, vulvovaginal atrophy, benign cervical ectopy and it has also been applied in reproductive medicine and erectile dysfunction (63)(64)(65)(66)(67)(68)(69).…”