The Effect of Use of Platelet Rich Plasma (PRP) on Venous Ulcer Size in Comparison to the Usual Method of Dressing and Compression Bandage

Abstract

Aim: To compare the clinical efficacy of platelet rich plasma in the management of chronic venous ulcers (as regards the time of complete ulcer healing or shrinkage in size) with the conventional methods of treatment of venous ulcers (compression and dressing alone).   Patients & methods:  A case control study was conducted over 40 patients having lower limb chronic venous ulcers, attending the outpatient clinic of vascular surgery, Ain Shams university hospitals in the period from July 2013 till January 2015. Twenty patients with chronic venous ulcers (cases) were treated with platelet rich plasma - topically applied to the ulcer then dressed by vasline gauze and compressed by graduated elastic stocking - for 6 sessions with one week interval between sessions. The second group (control) included the other 20 patients who were managed conservatively by compression using graduated elastic stockings below the knee and dressing using saline and vasline guaze weekly for 6 weeks.   Results: We noticed that the percentage of change in size, length and width of the ulcer after the end of treatment showed highly statistically significant difference between cases and controls after 6 weeks of treatment, where complete healing and shrinkage in size of the ulcer were more obvious in cases treated with PRP than those who were treated only by the conservative method, who showed mild improvement after 6 weeks of conservative treatment. 35% of patients in cases group achieved complete healing compared to 0% of patients in control group.   Conclusion: Platelet rich plasma shows promise as an effective treatment modality in the setting of chronic venous leg ulcers. It was found to be effective in enhancing wound healing in chronic venous leg ulcers when compared to conventional methods of treatment (compression + dressing), as regards length, width and size of the ulcer and treatment outcome