Efficacy of platelet rich plasma in chronic leg ulcers: a prospective randomized controlled study
Keywords:Chronic ulcers, Platelet rich plasma, PRP
Background: Chronic wounds affect approximately 1-2% of the population in Europe and the United States. Platelet rich plasma (PRP) has emerged as an effective, inexpensive, minimally invasive treatment modality for chronic leg ulcers. Objective of the study was to evaluate the efficacy of PRP, and to compare the effectiveness of PRP to regular antiseptic dressing in the management of chronic leg ulcers.
Methods: A hundred patients with chronic leg ulcers of more than 6 weeks duration were randomized into two groups (PRP and conventional dressing group). Patients in the PRP group received weekly intradermal injections of PRP to the wound in addition to conventional daily dressings till complete healing of the ulcers or up to a maximum of 6 weekly PRP sessions. Percentage of improvement in the area and volume of the ulcers were recorded. Patients were followed up at 1 month post PRP treatment.
Results: The mean reduction in the area of the ulcers at the end of 6 weeks was 66.39% in the PRP group and 28.6% in the control group. The mean reduction in volume of the ulcers at the end of 6 weeks was 71.80% and 37.88% in the case and control group respectively. At the end of 1 month post treatment follow-up, 74% and 10% of the ulcers treated with PRP and with conventional dressing respectively showed complete healing.
Conclusions: Leg ulcers treated with PRP showed a significantly higher reduction in the area and volume of the ulcers compared to ulcers treated with conventional moist dressing.
Lazarus GS, Cooper DM, Knighton DR, Margolis DJ, Pecoraro RE, Rodeheaver G, et al. Definitions and guidelines for assessment of wounds and evaluation of healing. Arch Dermatol. 1994;130:489-93.
Park J, Hwang S, Yoon IS. Advanced Growth Factor Delivery Systems in Wound Management and Skin Regeneration. Molecules. 2017;22:1259.
Shukla VK, Ansari MA, Gupta SK. Wound Healing Research: A Perspective From India. Int J Low Extrem Wounds. 2005;4:7-8.
Sen CK, Gordillo GM, Roy S, Kirsner R, Lambert L, Hunt TH, et al. Human skin wounds: A major and snowballing threat to public health and the economy. Wound Repair Regen. 2009;17:763-71.
Jones J. Winter’s concept of moist wound healing: a review of the evidence and impact on clinical practice. J Wound Care. 2005;14:273-6.
Demidova-Rice TN, Hamblin MR, Herman IM. Acute and Impaired Wound Healing: Pathophysiology and Current Methods for Drug Delivery, Part 1. Adv Skin Wound Care. 2012;25:304-14.
Chakrabarty D. One More Table of Random Two-Digit Numbers. Int J Adv Res Sci Eng Technol. 2016;3:13.
Suryanarayan S, Budamakuntla L, Khadri SS, Sarvajnamurthy S, et al. Efficacy of autologous platelet-rich plasma in the treatment of chronic nonhealing leg ulcers. Plast Aesthetic Res. 2014;1:65.
Lipsky BA, Berendt AR, Cornia PB, Pile JC , Peters EJG, Armstrong DG, et al. Infectious Diseases Society of America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infections. Oxf Univ Press. 2012;54:132-73.
Yuan T, Zhang CQ, Tang MJ, Guo SC, Zeng BF. Autologous Platelet-rich Plasma Enhances Healing of Chronic Wounds. Wounds. 2009;21:6.
Kakudo N, Kushida S, Minakata T, Suzuki K, Kusumoto K. Platelet-rich plasma promotes epithelialization and angiogenesis in a split thickness skin graft donor site. Med Mol Morphol. 2011;44:233-6.
Alves R, Grimalt R. A Review of Platelet-Rich Plasma: History, Biology, Mechanism of Action, and Classification. Skin Appendage Disord. 2018;4:18-24.
Li H, Li B. PRP as a New Approach to Prevent Infection: Preparation and In vitro Antimicrobial Properties of PRP. J Vis Exp. 2013;74:50351.
Cieślik-Bielecka A, Bold T, Ziółkowski G, Pierchała M, Królikowska A,Reichert P . Antibacterial Activity of Leukocyte- and Platelet-Rich Plasma: An In Vitro Study. BioMed Res Int. 2018;2018:1-8.
Marx RE. Platelet-Rich Plasma (PRP): What Is PRP and What Is Not PRP? Implant Dent. 2001;10:225-8.
Gopinath VPK, Simi VM, Basheer Ahammed K, Farisa PM, Ali Rishad CM. Intralesional autologous platelet rich plasma therapy in chronic nonhealing cutaneous ulcers: an interventional study from a tertiary care centre in North Kerala. Int J Res Dermatol. 2019;5:116.
Suthar M, Gupta S, Bukhari S, Ponemone V. Treatment of chronic non-healing ulcers using autologous platelet rich plasma: a case series. J Biomed Sci. 2017;24:16.
Park KY, Kim IS, Yeo IK, Kim BJ, Kim MN. Treatment of refractory venous stasis ulcers with autologous platelet-rich plasma and light-emitting diodes: a pilot study. J Dermatol Treat. 2013;24:332-5.
Anitua E, Aguirre JJ, Algorta J, Ayerdi E, Cabezas AI, Orive G, et al. Effectiveness of autologous preparation rich in growth factors for the treatment of chronic cutaneous ulcers. J Biomed Mater Res B Appl Biomater. 2008;84B:415-21.
Sarvajnamurthy S, Suryanarayan S, Budamakuntala L, Suresh DH. Autologous platelet rich plasma in chronic venous ulcers: Study of 17 cases. J Cutan Aesthetic Surg. 2013;6:97