DOI: http://dx.doi.org/10.18203/2349-2902.isj20191484

A comparative study on the efficacy of platelet rich plasma vs conventional wound dressing in diabetic foot ulcers

Sakthivel Velayutham, Parthasarathy Velayutham

Abstract


Background: The pathogenetic pathways and morbidity associated with diabetic foot ulcers render it a difficult clinical entity to manage. Newer biological methods such as platelet-rich plasma (PRP) are being investigated as improvements on conventional treatment techniques such as saline gauze antiseptic dressings.

Methods: The present study is a randomised controlled trial, with 25 subjects each in the PRP dressing and conventional dressing arms. It was conducted in the General Surgery wards of a tertiary care hospital among patients suffering from foot ulcers due to diabetes mellitus. PRP dressings were done biweekly for 4 weeks before final wound assessment.

Results: Most of the study population was males of more than 50 years of age. The lesions are predominantly on the plantar aspect. The inciting factor was trauma in around two-thirds of the cases. Nearly 80% of the subjects were on insulin for treatment. In the patients receiving treatment using PRP dressings, the wound contracted by more than 34% which was statistically significantly higher than those receiving conventional dressings.

Conclusions: Newer biological methods such as platelet-rich plasma (PRP) dressings offer a relatively novel safe and efficient technique for management of diabetic foot ulcers, compared to conventional methods.


Keywords


Diabetic foot ulcer, Platelet-rich plasma, Wound healing

Full Text:

PDF

References


Adeghate J, Nurulain S, Tekes K, Fehér E, Kalász H, Adeghate E. Novel biological therapies for the treatment of diabetic foot ulcers. Expert Opin Biol Ther. 2017;17(8):979–87.

Dietrich I, Braga GA, de Melo FG, da Costa Silva Silva ACC. The Diabetic Foot as a Proxy for Cardiovascular Events and Mortality Review. Curr Atheroscler Rep. 2017;19(11):44.

Kasiewicz LN, Whitehead KA. Recent advances in biomaterials for the treatment of diabetic foot ulcers. Biomater Sci. 2017;5(10):1962–75.

Sinwar PD. The diabetic foot management - recent advance. Int J Surg. 2015;15:27–30.

Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y. Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis. Ann Med. 2017;49(2):106–16.

Mishra SC, Chhatbar KC, Kashikar A, Mehndiratta A. Diabetic foot. BMJ. 2017;359:j5064.

Tindong M, Palle JN, Nebongo D, Aminde LN, Mboue-Djieka Y, Mbarga NTF, et al. Prevalence, Clinical Presentation, and Factors Associated With Diabetic Foot Ulcer in Two Regional Hospitals in Cameroon. Int J Low Extrem Wounds. 2018;17(1):42–7.

Ogbera OA, Osa E, Edo A, Chukwum E. Common clinical features of diabetic foot ulcers: perspectives from a developing nation. Int J Low Extrem Wounds. 2008;7(2):93–8.

Perez-Zabala E, Basterretxea A, Larrazabal A, Perez-Del-Pecho K, Rubio-Azpeitia E, Andia I. Biological approach for the management of non-healing diabetic foot ulcers. J Tissue Viability. 2016;25(2):157–63.

Mohammadi MH, Molavi B, Mohammadi S, Nikbakht M, Mohammadi AM, Mostafaei S, et al. Evaluation of wound healing in diabetic foot ulcer using platelet-rich plasma gel: A single-arm clinical trial. Transfus Apher Sci. 2017;56(2):160–4.

Ahmed M, Reffat SA, Hassan A, Eskander F. Platelet-Rich Plasma for the Treatment of Clean Diabetic Foot Ulcers. Ann Vasc Surg. 2017;38:206–11.

Babaei V, Afradi H, Gohardani HZ, Nasseri F, Azarafza M, Teimourian S. Management of chronic diabetic foot ulcers using platelet-rich plasma. J Wound Care. 2017;26(12):784–7.

Driver VR, Hanft J, Fylling CP, Beriou JM, Autologel Diabetic Foot Ulcer Study Group. A prospective, randomized, controlled trial of autologous platelet-rich plasma gel for the treatment of diabetic foot ulcers. Ostomy Wound Manage. 2006;52(6):68–70.

Mehrannia M, Vaezi M, Yousefshahi F, Rouhipour N. Platelet rich plasma for treatment of nonhealing diabetic foot ulcers: a case report. Can J Diabetes. 2014;38(1):5–8.

Hirase T, Ruff E, Surani S, Ratnani I. Topical application of platelet-rich plasma for diabetic foot ulcers: A systematic review. World J Diabetes. 2018;9(10):172–9.

Vicenti G, Bizzoca D, Caruso I, Nappi VS, Giancaspro G, Carrozzo M, et al. New insights into the treatment of non-healing diabetic foot ulcers. J Biol Regul Homeost Agents. 2018;32(6):15–21.

Pedras S, Carvalho R, Pereira Mda G. Sociodemographic and clinical characteristics of patients with diabetic foot ulcer. Rev Assoc Med Bras (1992). 2016;62(2):171–8.

Goda A, Metwally M, Ewada A, Ewees H. Platelet-rich plasma for the treatment of diabetic foot ulcer: a randomized, double-blind study. Egypt J Surg. 2018;37(2):178-84.

Tripathi K, Gupta P. Management of diabetic foot ulcers with platelet rich plasma: A clinical study. National J Clin Orthop. 2018;2(3):09–11.

Deshmukh NS, Belgaumkar VA, Tolat SN, Chavan RB, Vamja CJ. Platelet rich plasma in treatment of chronic non healing ulcers: a study of ten cases. Int J Res Dermatol. 2018;4(1):50–3.

Fernando ME, Crowther RG, Lazzarini PA, Sangla KS, Wearing S, Buttner P, et al. Plantar pressures are higher in cases with diabetic foot ulcers compared to controls despite a longer stance phase duration. BMC Endocrine Disorders. 2016;16(1):51.

Iraj B, Khorvash F, Ebneshahidi A, Askari G. Prevention of Diabetic Foot Ulcer. Int J Prev Med. 2013;4(3):373–6.

Rosyid FN. Etiology, pathophysiology, diagnosis and management of diabetics’ foot ulcer. Int J Res Med Sci. 2017;5(10):4206–13.

Singh SP, Kumar V, Pandey A, Pandey P, Gupta V, Verma R. Role of platelet-rich plasma in healing diabetic foot ulcers: a prospective study. J Wound Care. 2018;27(9):550–6.

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(1):16.