DOI: http://dx.doi.org/10.18203/2349-2902.isj20205371

Comparative study on management of diabetic ulcer with platelet-rich plasma and conventional dressing

Uma Dhanasekaran, Ramesh Arumugam, Latha Jayasubramaniyar

Abstract


Background: About 15% of diabetic patients will develop a chronic ulcer, and about 25% of those will have to undergo foot amputation. Despite evidence of the effectiveness of autologous protein C (PC) in diabetic ulcers, efficacy and feasibility of this treatment in the general population remain unclear. Aim of the study was to compare the efficiency of management of diabetic ulcer with platelet-rich plasma (PRP) and conventional dressing.

Methods: A total of 40 patients who divided into two groups: group I comprising 20 patients received homologous platelet concentrate and group II comprising 20 patients received conventional wound dressing, and the results had statistically discussed.

Results: Out of total 40 patients, 20 received homologous platelet dressings, and the 20 patients received conventional moist wound dressings. 7 patients had operated for split skin grafting, 7 patients had 0-10% of the area covered with necrotic tissue, mean duration of hospital stay was 18 days, mean duration of wound debridement was 3 days and mean number of wound dressing was 6. In conventional wound dressing group, 15 patients had operated for split skin grafting, 4 patients had 0-10% of the area covered with necrotic tissue, mean duration of hospital stay was 39 days, mean duration of wound debridement was 18 days and mean number of wound dressing was 48.

Conclusions: Patients operated for split skin grafting, number of wound debridement, duration of hospital stay, and duration of wound debridement, necrotic tissue coverage was less in platelet group compared to the conventional wound dressing.


Keywords


Diabetes mellitus, Ulcer, Debridement, Granulation tissue

Full Text:

PDF

References


Ahmad J. The diabetic foot. Diabetes Metab Syndr. 2016;10:48-60.

Naidoo P, Liu VJ, Mautone M, Bergin S. Lower limb complications of diabetes mellitus: a comprehensive review with clinic pathological insights from a dedicated high-risk diabetic foot multidisciplinary team. Br J Radiol. 2015;88:20150135.

McNeely MJ, Boyko EJ, Ahroni JH, Stensel VL, Reiber GE, Smith DG, Pecoraro RF. The independent contributions of diabetic neuropathy and vasculopathy in foot ulceration. How great are the risks? Diabetes Care. 1995;18:216-9.

Chen Y, Ding H, Wu H, Chen HL. The Relationship Between Osteomyelitis Complication and Drug-Resistant Infection Risk in Diabetic Foot Ulcer: A Meta-analysis. Int J Low Extreme Wounds. 2017;16:183-90.

Everett E, Mathioudakis N. Update on the management of diabetic foot ulcers. Ann N Y Acad Sci. 2018;1411:153-65.

Mohammadi MH, Molavi B, Mohammadi S, Nikbakht M, Mohammadi AM, Mostafaei S, Norooznezhad AH, GhorbaniAbdegah A, Ghavamzadeh A. Evaluation of wound healing in diabetic foot ulcer using platelet-rich plasma gel: A single-arm clinical trial. Transfus Apher Sci. 2017;56:160-4.

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.

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

Saad-Setta H, Elshahat A, Elsherbiny K, Massoud K, Safe I. Platelet-rich plasma versus platelet-poor plasma in the management of chronic diabetic foot ulcers: a comparative study. Int Wound J. 2011;8:307-12.

Kakagia DD, Kazakos KJ, Xarchas KC, Karanikas M, Georgiadis GS, Tripsiannis G, Manolas C. Synergistic action of protease modulating matrix and autologous growth factors in healing of diabetic foot ulcers. A prospective randomized trial. J Diabetes Complications. 2007;21:387-91.

Motolese A, Vignati F, Antelmi A, Saturni V. Effectiveness of platelet-rich plasma in healing necrobiosis lipoidicadiabeticorum ulcers. Clin Exp Dermatol. 2015;40:39-41.

Shan GQ, Zhang YN, Ma J, Li YH, Zuo DM, Qiu JL, Cheng B, Chen ZL. Evaluation of the effects of homologous platelet gel on healing lower extremity wounds in patients with diabetes. Int J Low Extreme Wounds. 2013;12:22-9.

Kontopodis N, Tavlas E, Papadopoulos G, Pantidis D, Kafetzakis A, Chalkiadakis G, Ioannou C. Effectiveness of Platelet-Rich Plasma to Enhance Healing of Diabetic Foot Ulcers in Patients with Concomitant Peripheral Arterial Disease and Critical Limb Ischemia. Int J Low Extreme Wounds. 2016;15:45-51.

Assoian RK, Fleurdelys BE, Stevenson HC, Miller PJ, Madtes DK, Raines EW, Ross R, Sporn MB. Expression and secretion of type beta transforming growth factor by activated human macrophages. Proc Natl Acad Sci USA. 1987;84:6020-4.

Banks RE, Forbes MA, Kinsey SE, Stanley A, Ingham E, Walters C, Selby PJ. Release of the angiogenic cytokine vascular endothelial growth factor (VEGF) from platelets: significance for VEGF measurements and cancer biology. Br J Cancer. 1998;77:956-64.

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.

Tripathi K, Gupta P. Management of diabetic foot ulcers with platelet-rich plasma: A clinical study. National J Clin Orthop. 2018;2(3):9-11.

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

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.

Crovetti G, Martinelli G, Issi M. Platelet gel for healing cutaneous chronic wounds. Transfus Apher Sci. 2009;30:145-51.

Sunil Hanft J, Fylling P. A prospective, randomized, controlled trial of autologous platelet rich plasma for the treatment of diabetic foot ulcers. Ostomy Wound Manage. 2006;52(6):68-87.

Vickie Driver R, Jason Hanft, Carelyn Fylling P. A prospective, randomized, controlled trial of autologous platelet-rich plasma gel for the treatment of diabetic foot ulcers. Ostomy Wound Management. 2006;52(6):68-87.

Suryanarayan S, Budamakuntla L, Khadri SIS et al. Efficacy of Autologous platelet-rich plasma in the treatment of chronic non-healing leg ulcers. Plast Aesthetic Res. 2015;1:65-9.