Platelet Rich Plasma Dressing Research Articles

Clinical manifestations of allergic reactions and immunoglobulin E levels on allogeneic freeze-dried platelet-rich plasma (PRP) application

Link of Video Abstract: https://youtu.be/yS431sCL3VQ Background: Several studies have reported that modern wound dressings offer better results. Allogeneic PRP products in the form of injections and gels are available in the market, which helps accelerate wound healing without triggering an immunological reaction. Meanwhile, this study was carried out to investigate the Allogeneic Freeze-Dried PRP form, which is more practical, efficient, and safer. This study aims to determine the effect of Allogeneic Freeze-Dried PRP on human split-thickness skin graft donor wounds on clinical manifestations of allergic reactions and levels of Immunoglobulin E (IgE). Methods: A randomized Pre- and Post-test Control-Trial Group Design was conducted on patients with split-thickness skin graft donor wounds using Allogeneic Freeze-Dried PRP dressings at Dr. Soetomo General Hospital, Surabaya. Allergic manifestations were reviewed during the observation period of up to 4 days, and IgE levels were measured pre-test and 60 minutes post-application. A statistical comparison of results was carried out between the trial and control groups that used paraffin dressings. Results: A total of 36 patients were used as subjects, with 19 (52.78%) in the trial group and 17 (47.22%) in the control group, and their parameters were generally homogeneous. There were no clinical manifestations of allergic, changes in vital signs, and significant differences in IgE levels before and after application statistically in all study subjects (p>0.05). Conclusion: Application of Allogeneic Freeze-Dried PRP to human split-thickness skin graft donor wounds did not generate clinical manifestations of allergic reactions and an increase in IgE.

Role of Autologous Platelet Rich Plasma in the Management of Chronic Non Healing Ulcers

Background: Chronic non-healing leg ulcers are a major health problem worldwide and have great impact on personal, professional and social levels, with high cost in terms of human and material resources. The present study was conducted with an aim to demonstrate the efficacy of autologous platelet rich plasma (PRP) in chronic non-healing leg ulcers in comparison to conventional dressings. Methods: About 50 patients presenting with chronic non healing ulcers to the surgical outpatient department in a tertiary care centre over a period of one year were included in the study, of which 25 patients received autologous PRP dressings other 25 patients received conventional dressings. Ulcer measurements were taken on day 1, 15, 28 and 42 days. Results: The mean duration of healing of the ulcers was 3.9 weeks in PRP group and 6.2 weeks conventional dressing. PRP dressing group showed a reduction in ulcer size of about 45.50 percent as compared to 14.80 percent in conventional dressing group. Conclusion: Chronic non healing ulcers are often difficult to heal because they lack the necessary growth factors to maintain the healing process. Conventional therapies do not provide satisfactory healing, since these treatments are not able to provide the necessary growth factors (PDGF, EGF, VGEF etc.) which are essential for the healing process. PRP is a safe, affordable, biocompatible and simple office based procedure for the treatment of non-healing ulcers.

The Efficiency and Safety of Platelet-Rich Plasma Dressing in the Treatment of Chronic Wounds: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Recently, many clinical trials have applied platelet-rich plasma (PRP) dressings to treat wounds that have stopped healing, which are also called chronic wounds. However, the clinical efficiency of PRP dressings in treating chronic wounds is still controversial. Therefore, we conducted this study to compare PRP dressings with normal saline dressings in treating chronic wounds. Relevant randomized controlled trials focusing on utilizing PRP dressings in treating chronic wounds were extracted from bibliographic databases. Finally, 330 patients with chronic wounds, reported in eight randomized controlled trials, were included in this study. In total, 169 out of 330 (51.21%) were treated with PRP dressings, and 161 out of 330 (48.79%) were treated with normal saline dressings. The pooled results showed that the complete healing rate of the PRP group was significantly higher than that of saline group at 8 weeks and 12 weeks, respectively. In addition, there were no significant differences in wound infection and adverse events. Compared with normal saline dressing, the PRP dressing could effectively enhance the prognosis of chronic wounds. Furthermore, the PRP did not increase wound infection rate or occurrence of adverse events as an available treatment for chronic wounds.

Platelet-rich Fibrin versus Platelet-rich Plasma: A Study to Assess Efficacy as a Regenerative Medicine Strategy for Chronic Cutaneous Ulcers.

The management of nonhealing ulcers has been a major challenge clinically. Current therapies include debridement, offloading, etc., which show a poor response. Newer modalities include stem cells, platelet-derived growth factors, and fibrin glues, which reduce healing time. Platelets play a major role in wound healing through the secretion of growth factors, chemokines, etc. and have been an area of interest as a modality in regenerative medicine. The aim was to study the comparative efficacy of autologous platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) as a regenerative medicine strategy for chronic cutaneous ulcers. Forty-four ulcers of duration greater than six weeks were enrolled for a comparative study comprising two groups, each divided either into group A receiving PRF dressings or group B receiving PRP dressing for six weeks. The ulcer evaluation was performed at baseline, each weekly dressing, and a two-week follow-up. Primary efficacy was assessed by the percentage reduction in the volume of ulcers and re-epithelization at eight weeks. In total, 95.2% of ulcers in group A and 90.4% of ulcers in group B showed complete re-epithelization. One ulcer in group A and two ulcers in group B developed an infection. The recurrence of the ulcer was seen in four ulcers in the PRF group and three ulcers in the PRP group. Dressings done with PRF and PRP showed similar efficacy in the percentage reduction in the volume and re-epithelization of chronic cutaneous ulcers. Both dressings were associated with similar complications. PRF and PRP dressings provide a safe, efficacious, and inexpensive regenerative medicine strategy in the healing of chronic cutaneous ulcers.

A Net Meta-Analysis of the Effectiveness of Different Types of Dressings in the Treatment of Diabetic Foot.

Objective This is an analysis of the impact of a new dressing commonly used to treat diabetic foot (DFU). Methods Chinese and English databases were searched to collect clinical randomized controlled studies (RCTs) of various types of dressings for the treatment of DFU, and the healing rates of the different dressings were combined by reticulation meta-analysis. Results The aggregate of the 36 RCTs included in this study analysed the healing rates of nine dressings: conventional dressing, alginate dressing, chitosan dressing, hyaluronic acid dressing, platelet-rich plasma dressing, amniotic membrane dressing, honey dressing, human recombinant growth factor dressing, and silver ionomer dressing. Conclusion Hyaluronic acid dressing, amniotic membrane dressing, honey dressing, and platelet-rich plasma dressing are the ideal materials for topical treatment of DFU.

A comparative study on effect of platelet rich plasma Vs conventional dressing in healing rate of chronic diabetic ulcers

Introduction and Aim: This study has been undertaken to evaluate efficacy of platelet rich plasma (PRP) dressing that is recently introduced with conventional dressing. We have tried to compare PRP dressing with conventional normal dressing in healing the wound. Materials and Methods: We conducted this study in 120 patients of chronic non healing diabetic foot ulcers who were treated over the period of three years. Number of cases (60 each) were studied for efficacy of applying autologous platelet rich plasma versus normal dressing for chronic non healing diabetic foot ulcers. At every week follow up, the ulcer was examined for granulation tissue, area and volume which was calculated using Vernier calipers and marked on a graph paper and photographs were taken. Wound healing was compared between PRP and normal dressing. Results: The incidence of male susceptibility was more (70%) than females (30%) in diabetic foot. Average rate of healing per week was found to be significantly better among the PRP group than normal dressing group. The ulcer showed significant reduction in size among the PRP group in comparison to the normal dressing group with a significant P value (0.001). Conclusion: In this study application of platelet rich plasma into chronic non-healing diabetic foot ulcers in comparison with conventional dressing has shown a significant reduction in the size of the ulcer, hospital stay and cost for the patient.

Safety and efficacy of platelet rich plasma in the management of diabetic foot ulcer

Background: Diabetic foot ulcers continue to pose a significant global issue despite the advances made in the management of diabetes. It causes major foot complications if they are not addressed properly. While several advancements have taken place in wound care management, platelet-rich plasma (PRP) promises to offer new hope in its management, aiding in cellular and tissue regeneration. Hence the present study was carried out to determine the safety and effectiveness of PRP in the management of diabetic foot ulcers in comparison to conventional dressing.Methods: This prospective study was focused on 50 diabetic foot ulcers, carried out in a surgical unit of Onsite Hospital, Chennai, Tamil Nadu from November 2018 to November 2019. Patients were divided into two groups group A received conventional ordinary dressing (n=25, 50%) and group B received PRP dressing (n=25, 50%). The mean follow up period was 6 weeks.Results: The present study observed that participants receiving PRP showed better wound contraction of 33.74% than the group receiving only conventional treatment with a mean wound contraction of was 12.82%. In addition, the duration required for wound contraction in the PRP group was short (mean value 4.488 cm) compared to the conventional dressing group (mean value 6.188 cm). The PRP group was found to be more effective in wound healing with fewer complications, less infection, exudates and pain.Conclusions: PRP is a powerful tool for the treatment of chronic wounds and very promising for diabetic foot wounds and it enables healing and reduces amputation rates, infection and exudates.

Plasma-Based Bioinks for Extrusion Bioprinting of Advanced Dressings.

Extrusion bioprinting based on the development of novel bioinks offers the possibility of manufacturing clinically useful tools for wound management. In this study, we show the rheological properties and printability outcomes of two advanced dressings based on platelet-rich plasma (PRP) and platelet-poor plasma (PPP) blended with alginate and loaded with dermal fibroblasts. Measurements taken at 1 h, 4 days, and 18 days showed that both the PRP- and PPP-based dressings retain plasma and platelet proteins, which led to the upregulation of angiogenic and immunomodulatory proteins by embedded fibroblasts (e.g., an up to 69-fold increase in vascular endothelial growth factor (VEGF), an up to 188-fold increase in monocyte chemotactic protein 1 (MCP-1), and an up to 456-fold increase in hepatocyte growth factor (HGF) 18 days after printing). Conditioned media harvested from both PRP and PPP constructs stimulated the proliferation of human umbilical vein endothelial cells (HUVECs), whereas only those from PRP dressings stimulated HUVEC migration, which correlated with the VEGF/MCP-1 and VEGF/HGF ratios. Similarly, the advanced dressings increased the level of interleukin-8 and led to a four-fold change in the level of extracellular matrix protein 1. These findings suggest that careful selection of plasma formulations to fabricate wound dressings can enable regulation of the molecular composition of the microenvironment, as well as paracrine interactions, thereby improving the clinical potential of dressings and providing the possibility to tailor each composition to specific wound types and healing stages.

Efficacy of Intralesional Platelet-Rich Plasma in Diabetic Foot Ulcer.

Diabetic foot ulcer (DFU) is well managed by infection control, euglycemic state, and debridement of the ulcer followed by appropriate dressing and off-loading of the foot. Studies show that approximately 90% of DFUs that are properly off-loaded heal in nearly 6 weeks. Platelet-rich plasma (PRP) serves as a growth factor agonist and has mitogenic and chemotactic properties that help in DFU healing. We sought to evaluate the efficacy of local application of PRP with respect to healing rate and ulcer area reduction in treating DFUs. Sixty noninfected patients with DFUs (plantar surface area, ≤20 cm2; Meggitt-Wagner grades 1 and 2) were randomized to receive normal saline dressing (control group [CG]) or PRP dressing (study group [SG]) along with total-contact casting for 6 weeks or until complete ulcer healing, whichever was earlier. Healing rate and change in ulcer area were evaluated weekly. Mean ± SD ulcer area at baseline was 4.96 ± 2.89 cm2 (CG) and 5.22 ± 3.82 cm2 (SG) (P = .77), decreasing to 1.15 ± 1.35 cm2 (CG) and 0.96 ± 1.53 cm2 (SG) (P = .432) at 6 weeks. Mean ± SD percentage reduction in healing area at 6 weeks was 81.72% ± 17.2% (CG) and 85.98% ± 13.42% (SG) (P = .29). Mean ± SD healing rate at 6 weeks was 0.64 ± 0.36 cm2 (CG) and 0.71 ± 0.46 cm2 (SG) (P = .734). The PRP dressing is no more efficacious than normal saline dressing in the management of DFU in conjunction with total-contact casting.

A comparative study between platelet rich plasma and conventional dressing in chronic non healing leg ulcers

Background: Chronic non-healing leg ulcers are a major health problem worldwide and have great impact on personal, professional and social levels, with high cost in terms of human and material resources. The present study was conducted with an aim to demonstrate the efficacy of autologous platelet rich plasma (PRP) in chronic non-healing leg ulcers in comparison to conventional dressings.Methods: A total of 50 patients with leg ulcers were randomized into two groups (A and B) with each group comprising of 25 patients each. Group A were treated with autologous platelet rich plasma (PRP) dressings and group B were treated with conventional dressings using normal saline. Ulcer measurements were taken on day 1, day 7, days 15 and after 30 days. The end point of study was complete wound epithelialization or appearance of granulation tissue, which ultimately lead to spilt skin grafting or secondary healing; whichever is earlier.Results: There was statistically significant difference in the average time taken for complete healing of ulcer in PRP dressings, 3.68 weeks against 6.2 weeks in conventional dressing group (p value <0.0001). PRP dressing group showed a 43.96% reduction in ulcer size as compared to 13.81% in conventional dressing group (p <0.0001). It was observed that PRP dressing group has faster wound healing and contraction of wound.Conclusions: PRP dressing of leg ulcers was better than conventional normal saline dressing as it leads to early reduction of ulcer size and enhances rate of wound healing.

A comparative study on the efficacy of platelet rich plasma vs conventional wound dressing in diabetic foot ulcers

Background: The pathogenetic pathways and morbidity associated with diabetic foot ulcers render it a difficult clinical entity to manage. Newer biological methods such as platelet-rich plasma (PRP) are being investigated as improvements on conventional treatment techniques such as saline gauze antiseptic dressings.Methods: The present study is a randomised controlled trial, with 25 subjects each in the PRP dressing and conventional dressing arms. It was conducted in the General Surgery wards of a tertiary care hospital among patients suffering from foot ulcers due to diabetes mellitus. PRP dressings were done biweekly for 4 weeks before final wound assessment.Results: Most of the study population was males of more than 50 years of age. The lesions are predominantly on the plantar aspect. The inciting factor was trauma in around two-thirds of the cases. Nearly 80% of the subjects were on insulin for treatment. In the patients receiving treatment using PRP dressings, the wound contracted by more than 34% which was statistically significantly higher than those receiving conventional dressings.Conclusions: Newer biological methods such as platelet-rich plasma (PRP) dressings offer a relatively novel safe and efficient technique for management of diabetic foot ulcers, compared to conventional methods.

Autologous Platelet-Rich Plasma Reduces Healing Time of Chronic Venous Leg Ulcers: A Prospective Observational Study.

The study investigated whether the application of dressings with autologous platelet-rich plasma (PRP) would reduce the healing time in patients with chronic venous leg ulcers. This is a prospective observational study that included 100 patients diagnosed with lower extremity venous insufficiency complicated by ulceration of a leg or foot, who had been after angioplasty of stenotic artery. Patients were divided into two groups of 50 each: treated with PRP (study group) and treated with conventional hydrocolloid dressings (control group). We followed the wound changes at Day 10, Day 20, and Day 30 of treatment and compared them with the baseline appearance at Day 0. We evaluated the appearance, area, and depths of wounds with ultrasound. The granulation process was examined histologically to document skin formation and wound tissue neovascularization. The findings were that treatment with PRP dressings resulted in a significant progressive reduction in ulcer size, irrespective of the ulcer's initial size, compared to treatment with conventional dressings. Further, the best effect of PRP was noticed in the category of largest wounds. After a month of treatment with PRP dressings, more than 50% of all ulcers were completely healed. The young epidermis appeared together with the granulation tissue, and the formation of dermis took shape after 20days of treatment. We conclude that the use of PRP dressings is a safe, nonsurgical adjunctive procedure for treating chronic venous leg ulcers. The potential benefit of PRP dressings over conventional ulcer treatment requires further in-depth exploration.

Efficacy of Homologous, Platelet-rich Plasma Dressing in Chronic Non-healing Ulcers: An Observational Study.

BackgroundChronic non-healing ulcers are a frequent problem in developing countries and represent a heavy burden to the patients because they lack the necessary growth factors (GFs) to maintain the healing process and are frequently complicated by super, added infections. Traditional therapies, such as regular dressings and wound debridement, cannot provide satisfactory results since these treatments are not able to provide the necessary GFs. Platelet-rich plasma (PRP) helps in enhancing the wound healing by releasing various GFs. The aim was to evaluate the efficacy of PRP dressing in the treatment of chronic non-healing ulcers.MethodsPatients attending the outpatient department on a regular basis and those admitted as inpatients for chronic wound management were included in the study. It was an observational study done in a tertiary health center for a period of one year. All patients with eligible criteria were treated with PRP at twice-weekly intervals for a maximum of 10 dressings. At the end of the five weeks period, the reduction in the size of the ulcers (area and volume) was assessed.ResultsA total of 104 cases with chronic non-healing ulcers of various causes were treated with homologous PRP twice weekly for a maximum of 10 dressings. In those 104 patients, non-healing ulcers in 85 patients (81.73%) were healed at the end of the last dressing. Non-healing ulcers in 13 patients (12.5%) were healed with skin grafting. Among those patients, the baseline mean ulcer area was 5.03 cm2. For each visit, there was a reduction in the ulcer area. At the end of the last visit, the mean ulcer area was 1.69 cm2, which was significant in this study.ConclusionDue to the lack of necessary GFs in chronic non-healing ulcers, PRP is safe and enhances the healing rates of chronic wounds, thereby reducing overall hospital stay and morbidity.

Platelet-rich plasma versus conventional dressing: does this really affect diabetic foot wound-healing outcomes?

Purpose This study aimed to compare platelet-rich plasma (PRP) versus conventional ordinary dressing in the management of diabetic foot wounds. Background Diabetic foot wound treatment poses a considerable burden on the medical system, with long waiting times for healing in the public hospital system. PRP enables efficient treatment of many patients with hemostatic, anti-inflammatory, and analgesic substances. Patients and methods This prospective study was focused on 80 diabetic feet wounds. Patients were divided into two groups: group A received conventional ordinary dressing (N=40, 50%) and group B received PRP dressing (N=40, 50%). The mean follow-up period was 12 weeks. Results The estimated time of wound healing was 12 weeks for 82.5% of the patients in group A and 97.5% of the patients in group B; the PRP group was found to be more effective with fewer complications, less infection, exudates, pain, and failed healing: 17.5, 12.5, 32.5, and 2.5% versus 27.5, 42.5, 62.5, and 17.5% in group B, respectively (P=0.001). The highest healing rate was observed for both groups at the fourth week, but it was better for the PRP group (group B): 0.89±0.13 versus 0.49±0.11 cm2/week in group A. Conclusion There have been considerable advancements in the use of PRP in therapeutic processes in recent years in tissue regeneration therapy. PRP is a powerful tool for the treatment of chronic wounds and very promising for diabetic foot wounds; PRP enables healing, and reduces infection rates and exudates.