Decubitus Ulcer in a Patient with Non-Hodgkin Linfoma Treated with Topic Collagenase with Hyaluronic Acid and PRP: Case Report and Literature Review

Abstract

Introduction: Gradual increase in the elderly population in recent years is posing great health challenges and ulcers are one of the major challenges for the patients that are bedridde due to hematologic issues. They are commonly affected by ulcers. Beyond standard treatments, new approach to treat skin ulcers has become the application of topical growth preparations as PRP. Case Report: We are reporting a case of a 62-year-old male patient affected by non-Hodgkin Linfoma with paraparesis due to a compression over the bone marrow caused due to Linfoma. The prolonged bedridden condition had led to a voluminous class III-IV decubitus ulcer in the sacral region of 20 x 15 cm. We performed a standard medication for the injury for 5 weeks, which consisted in traditional disinfection, cleansing with physiological solution and application of topic collagenase. There was improvement and the wound started healing gradually, when treatmented with 8 cycles of piastrinic gel therapy. After six weeks of PRP treatment, the patient exhibited tremendous improvement. Production of hemocomponent: The platelet gel was obtained by autologous automatic procedure with multicomponent collection. The platelet count was significantly high and the WBC count was 10 times higher than baseline values of peripheral blood. Cryoprecipitate was obtained and mixed with leucoplatelet concentrate for enrichment and then splitted into 8 small bags. We succeed to reach a high cellular concentration without G-CSF patient stimulation and the procedure was well tolerated by the patient. Discussion: PRP method consists of collection and concentration of platelets that can release powerful growthfactors and there by cure the wound. Its positive effect is due to released lipoxins, antimicrobial effects, recruitment of undifferentiated cells and promotion of type I collagen formation and MMPs gene expression. It is a cheap and minimally invasive method. A quick review of literature and medical cases reveled the proofs for skin ulcers treated with PRP. This is helpful in treating the present case affected with skin ulcersand the study discusses how this can be managed through PRP application.Conclusion: The study concludes that it is possible to reduce the diameter of the soer and clear the bottom by applying PRP for a patient suffering from non-Hodgkin Linfoma. The study couold prove this treatment as safe with no risk of infection and it improves the quality of life of the patient. This study could establish that PRP application ensures faster healing with minimal or no hospitalization and very low medication.