DOI: https://dx.doi.org/10.18203/2349-2902.isj20214843
Published: 2021-12-28

Safety and efficacy of platelet rich plasma in the management of diabetic foot ulcer

Raju Rani, Kathirvel Priyanka

Abstract


Background: Diabetic foot ulcers continue to pose a significant global issue despite the advances made in the management of diabetes. It causes major foot complications if they are not addressed properly. While several advancements have taken place in wound care management, platelet-rich plasma (PRP) promises to offer new hope in its management, aiding in cellular and tissue regeneration. Hence the present study was carried out to determine the safety and effectiveness of PRP in the management of diabetic foot ulcers in comparison to conventional dressing.

Methods: This prospective study was focused on 50 diabetic foot ulcers, carried out in a surgical unit of Onsite Hospital, Chennai, Tamil Nadu from November 2018 to November 2019. Patients were divided into two groups group A received conventional ordinary dressing (n=25, 50%) and group B received PRP dressing (n=25, 50%). The mean follow up period was 6 weeks.

Results: The present study observed that participants receiving PRP showed better wound contraction of 33.74% than the group receiving only conventional treatment with a mean wound contraction of was 12.82%. In addition, the duration required for wound contraction in the PRP group was short (mean value 4.488 cm) compared to the conventional dressing group (mean value 6.188 cm). The PRP group was found to be more effective in wound healing with fewer complications, less infection, exudates and pain.

Conclusions: PRP is a powerful tool for the treatment of chronic wounds and very promising for diabetic foot wounds and it enables healing and reduces amputation rates, infection and exudates.


Keywords


Diabetic foot ulcer, Diabetic foot, Platelet-rich plasma, Platelet, Foot ulcer

Full Text:

PDF

References


Rosenfeld L. Insulin: discovery and controversy. Clin Chem. 2002;48:2270-88.

Pickwell K, Siersma V, Kars M, Apelqvist J, Bakker K, Edmonds M, et al. Predictors of lower-extremity amputation in patients with an infected diabetic foot ulcer. Diabetes Care. 2015;38(5):852-7.

Sebastian KMS, Lobato I, Hernandez I, Burgos-Alonso N, Gomez-Fernandez MC, López JL, et al. Efficacy and safety of autologous platelet rich plasma for the treatment of vascular ulcers in primary care: phase III study. BMC Fam Pract. 2014;15:211.

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):1-0.

Pavlovic V, Ciric M, Jovanovic V, Stojanovic P. Platelet Rich Plasma: a short overview of certain bioactive components. Open Med (Wars). 2016;11(1):242-7.

Saad 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(3):307-12.

Alsousou J, Thompson M, Hulley P, Noble A, Willett K. The biology of platelet-rich plasma and its application in trauma and orthopaedic surgery: a review of the literature. J Bone Joint Surg Br. 2009;91(8):987-96.

Edmonds ME, Blundell MP, Morris ME, Thomas EM, Cotton LT, Watkins PJ. Improved survival of the diabetic foot: the role of a specialised foot clinic. Q J Med. 1986;60(2):763-71.

Prabhu R, Vijayakumar C, Bosco Chandra AA. Efficacy of homologous, platelet-rich plasma dressing in chronic non-healing ulcers: an observational study. Cureus. 2018;10(2):2145.

Giacco F, Perruolo G, D’Agostino E, Fratellanza G, Perna E, Misso S, et al. Thrombin-activated platelets induce proliferation of human skin fibroblasts by stimulating autocrine production of insulin-like growth factor-1. FASEB J. 2006;20(13):2402-4.

Gui-Qiu S, Zhang B, Jing M, Yan-Hui L, Da-Ming Z, Jin-Lang Q, et al. Evaluation of the effects of homologous platelet gel on healing lower extremity wounds in patients with diabetes. Int J Low Extrem Wounds. 2013;12(1):22-9.

Martinez-Zapata MJ, Martí-Carvajal AJ, Solà I, Expósito JA, Bolíbar I, Rodríguez L. Autologous platelet-rich plasma for treating chronic wounds. Cochrane Database Syst Rev. 2012;10:89-92.

DeLeon MJ, Driver VR, Fylling CP, Carter MJ, Anderson C, Wilson J, et al. The clinical relevance of treating chronic wounds with an enhanced nearphysiological concentration of PRP gel. Adv Skin Wound Care. 2011;24(8):357-68.