Abstract
The aim of the study was to evaluate the effectiveness of local using of autologous platelet-rich plasma in the treatment of patients with diabetic foot in stage 2. The study included 25 patients with a diagnosis of diabetic foot in stage 2. At the time of inclusion in the study, all patients had a defect of 3–7 cm2 of the skin and subcutaneous adipose tissue in the plantar part of the foot. In addition to the standard treatment, it was decided to perform the local administration of autologous platelet-rich plasma in all patients. The entire platelet-rich plasma volume obtained was injected in the edge of skin around the wound using 30-gauge needles. Repeated injections were performed every 5–7 days until complete healing of the soft tissue defect. To evaluate the effectiveness of the treatment, the area of the ulcerative defect was measured before the manipulation, as well as at an interval of 14 days until the ulcer was completely healed. The following results are obtained: prior to the manipulation, the area of ulcerative defects in the examined population was 511.9±120.3 mm2. On the 14th day, this indicator was already 353.6±112.5 mm2 and was significantly different from the area of the ulcerative defects before manipulation (p<0.01). On the 28th day, complete healing of diabetic ulcers was observed in 11 (44%) patients, and the area of the skin defect in the study population was 22.4±24.3 mm2 and was significantly different from those in all previous study dates (p<0.01). On day 42, we noted the complete healing of ulcers in absolutely all patients. Thus, local injection of an autologous platelet-rich plasma improves the local regenerative process and leads to complete healing of stage 2 diabetic ulcers with an area of 3–7 cm2 for 6 weeks.
Highlights
Diabetes mellitus is a metabolic disease with main symptom of hyperglycemia caused by impaired insulin secretion and/or insulin interaction with tissue cells
The prevalence of ulcerative lesions of the lower extremities caused by diabetes mellitus is estimated to be in the range of 4-10%
On the 28th day, complete healing of diabetic ulcers was observed in 11 (44%) patients, and the area of the skin defect in the study population was 22.4±24.3 mm2 and was significantly different from those in all previous study dates (p
Summary
Diabetes mellitus is a metabolic disease with main symptom of hyperglycemia caused by impaired insulin secretion and/or insulin interaction with tissue cells. The prevalence of ulcerative lesions of the lower extremities caused by diabetes mellitus is estimated to be in the range of 4-10%. In a cohort of patients with diabetic foot, approximately 12-20% of patients need the performing of amputations [1, 4]. In addition to the problem of diabetic angiopathy and neuropathy, attention should be paid to the fact that the condition of patients with diabetic foot may be complicated by the addition of infection, atherosclerosis of peripheral arteries [3]. Long-lasting ulcers are a serious complication in patients with diabetes. Diabetes is not amenable to radical treatment, and ulcerative lesions of the foot, which is the most frequent localization of the process, are difficult to treat [2]
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