To Evaluate Antimicrobial Properties of Platelet Rich Plasma and Source of Colonization in Pressure Ulcers in Spinal Injury Patients

Abstract

Background. Exposure of pressure ulcers (PrUs), particularly to urine and feces, leads to increased colonization of wounds. The aim of the present study was to evaluate the source of microbial colonization and antimicrobial properties of autologous platelet rich plasma (PRP) in controlling it in PrUs.Methods. Twenty-five patients of spinal cord injury (SCI) with at least two PrUs were taken for the study. Local application of autologous PRP on one PrU (case) was compared with saline dressing on the other PrU (control). Urine cultures, urethral meatus, PrUs, and perineal swabs were taken at weekly interval for five weeks.Result. Colonization rate of PrUs (case) decreased from 92% at enrollment to 24% at the 5th week but did not significantly decrease in PrUs (control) from enrollment (84%) to the 5th week (76%). Association between PrU (case) and perineal cultures was observed forStaphylococcus aureusat enrollment 41% (χ2=6.76,P<0.01) and at the 2nd week 47% (χ2=5.83,P<0.05). 47% association between PrU (control) and perineal cultures at enrollment (χ2=4.11,P<0.05) and 29% association at the 2nd week (χ2=8.41,P<0.01) were observed forStaphylococcus aureus. There was association between bacteria present in perineum/urine and those colonizing PrUs.Conclusion. There is a significant association between PrUs colonization and bacteria present in local environment (urine and feces). Local application of autologous PRP changes the “biological milieu” of the PrUs through its antimicrobial properties leading to reduction in bacterial colonization.