Published: 2019-10-21

Efficacy of autologous platelet rich fibrin matrix in the management of non-healing ulcers

Prachi V. Gole, Naziya Muhammed, Siddhi R. Patadia


Background: Non healing ulcers have a worldwide prevalence of 1.9%-13.1% with lower extremity being the commonest site. They are difficult to manage for the physician and frustrating for the patient due longer duration of treatment, cost, unsatisfactory outcomes and impairment caused due to them. Standard conventional management may fail at times and hence growth factors derived from platelets have been tried in the management of these ulcers. The purpose of our study was to evaluate the efficacy of platelet rich fibrin matrix (PRFM) in treatment of these ulcers.

Methods: Twelve patients with fifteen non-healing ulcers more than 3 months duration were included in the study. 10cc of venous blood was withdrawn in plain tube without anti-coagulants and centrifuged at 1500 rpm for 14 minutes as early as possible as per advanced PRF protocol. Middle layer of PRFM was applied to the clean ulcer followed by a secondary dressing. All patients received PRFM sittings every 7-10 days or till ulcer healed. Baseline photographs and measurements of length, breadth and depth were taken to calculate the area of ulcer at every sitting.

Results: The average percentage reduction in area and volume of the ulcer was 95.84% and 98.18% respectively at the end of six sittings. Twelve out of fifteen ulcers showed complete healing by 6 weeks, while three ulcers showed significant improvement but did not heal completely. The procedure was safe, well tolerated without any side effects.

Conclusions: Platelet rich fibrin matrix is a novel modality and an ideal, safe, affordable therapeutic option for non-healing wounds of varied causes.


Non healing ulcers, Platelet rich plasma, Platelet rich fibrin matrix, Growth factors

Full Text:



Rayner R, Carville K, Keaton J, Prentice Jl, Santamaria N. Leg ulcers: atypical presentations and associated co-morbidities. Wound Pract Res. 2009;17(4):168-85.

Agale SV. Chronic leg ulcers: epidemiology, aetiopathogenesis, and management. Ulcers. 2013:413604:9.

Suresh DH, Suryanarayan S, Sarvainamurthy S, Puvvadi S. Treatment of a Non-healing diabetic foot ulcer with platelet rich plasma. J Cutan Aesthet Surg. 2014;7(4):229-31.

Davis VL, Abukabda AB, Radio NM, Witt-Enderby PA, Clafshenkel WP, Cairone JV, et al. Platelet-Rich Preparations to Improve Healing. Part I: Workable Options for Every Size Practice. J Oral Implantol. 2014;40(4):500-10.

Suryanarayan S, Budamakuntla L, Khadri SIS, Sarvajnamurthy S. Efficacy of autologous platelet-rich plasma in the treatment of chronic nonhealing leg ulcers. Plast Aesthet Res. 2014;1:65-9.

Etulain J. Platelets in wound healing and regenerative medicine. Platelets. 2018;29(6):556-68.

Gawaz M, Vogel S. Platelets in tissue repair: control of apoptosis and interactions with regenerative cells. Blood. 2013;122:2550-4.

Choukroun J, Adda F, Schoeffler C, Vervelle A. Une opportunitéenparo-implantologie: Le PRF. Implantodontie. 2001;42:55-62.

Ghanaati S, Booms P, Orlowska A, Kubesch A, Lorenz J, Rutkowski J, et al. Advanced platelet-rich fibrin: a new concept for cell-based tissue engineering by means of inflammatory cells. J Oral Implantol. 2014;40:679-89.

Eizaburo Kobayashi et al. Comparative release of growth factors from PRP, PRF, and advanced-PRF. Clin Oral Invest. 2016;20:2353-60.

Yazawa M, Ogata H, Nakajima T, Mori T, Watanabe N, Handa M. Basic studies on clinical applications of platelet rich plasma. Cell Transplant. 2003;12:509-18.

Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet rich fibrin(PRF): A second grneration platelet concentrate. Part II:Platelet related biologic features. Oral Surg Oral Med Oral Pathol Radiol Endod. 2006;101:45-50.

Nagaraju U, Sundar P, Agarwal P, Raju B, Kumar M. Autologous platelet rich fibrin matrix in non-healing trophic ulcers in patients with Hansen’s disease. J CutanAesthet Surg. 2017;10:3-7.

Sarvajnamurthy S, Suryanarayan S, Budamakuntala L, Suresh DH. Autologous platelet rich plasma in chronic venous ulcers: Study of 17 cases. J Cutan Aesthet Surg. 2013;6:97-9.

Toffler M, Toscano N, Holtzclaw D, Corso MD, Dohan Ehrenfest DM. Introducing Choukroun’s platelet rich fibrin (PRF) to the reconstructive surgery milieu. J Implant Adv Clin Dent. 2009;1:21-30.

Kumar RV, Shubhashini N. Platelet rich fibrin: A new paradigm in periodontal regeneration. Cell Tissue Bank. 2013;14(3):453-63.