Management of Chronic Non-Healing Ulcers by Topical Application of Platelet Rich Plasma (PRP)

Abstract

Disturbance of the normal anatomic structure and functional integrity of the skin can be described as wound. Chronic or non-healing ulcers are defined as ulcers which are failed to heal in less than 3 weeks of duration .If normal healing process is interrupted ulcer can become chronic in nature due to lack of growth factors and cytokines which is results in delay of wound healing. Conventional treatment for chronic non-healing ulcers includes wound cleansing and necrotic tissue debridement. The use of patient’s own body cells for ulcer treatment relies upon the components present in the blood and platelet concentrate, which contains various cytokines and growth factors. Autologous PRP is a platelet suspension in plasma derived from whole blood that is increasingly being used in clinical practice for the treatment of chronic non healing ulcers. OBJECTIVE: To assess the efficacy of topical application of autologous platelet rich plasma in wound healings. METHODOLOGY: The study was conducted in the department of General Surgery, GREAT EASTERN MEDICAL SCIENCES during the period of February 2021 to February 2022 . Ten patients between 18-80 yrs ,of any sex, with chronic non-healing ulcers of different etiologies were treated with topical application of PRP. RESULTS : Ten patients each having ulcer of varying etiology were included .Treated with Topical administration of AUTOLOGOUS PRP solution over the ulcer. Among the included patients 6(60%) were males and 4 (40%) were females with a mean age of 62.5± 13.53 years. Out of 10 patients 4(40%) were in 61-80 years age group,2(20%)were in 41-60 years age group and 4(40%) patients was less than 40 years .The duration of the chronic non healing ulcers presented by the patients range from 9 to 24 weeks with a mean duration of 16weeks.After application of PRP solution ,the mean healing time was found to be almost 8.2 weeks±1.9weeks.After the application of PRP solution small islands of granulating tissue appeared over the wound and a significant reduction in ulcer size was observed as a sign of healing and improvement. CONCLUSION: In our study, the results showed that PRP is a safe and effective treatment modality for chronic non-healing ulcers. Delivering of growth factors to target site enhances the wound healing rates of chronic non healing ulcers.PRP seems to be efficient to treat chronic non healing ulcers which are non responsive to classical conservative treatments. Using PRP to treat chronic wounds/ulcers may not only enhance healing, but also prevent lower extremity amputations caused by nonhealing wounds.There by reducing over all hospital stay, inconvenience of constant medication and morbidity.