Treatment Of Non-healing Ulcers Research Articles

Role of Platelet Rich Fibrin Matrix (PRFM) in Pressure Injury Management

Platelet-rich fibrin matrix, which is rich in growth factors, has been demonstrated to be beneficial in the treatment of non-healing ulcers in recent research. Aim of this study is to evaluate the role of Platelet Rich Fibrin Matrix (PRFM) in pressure injury management. In our study, after two session of Platelet Rich Fibrin Matrix (PRFM) application, the pressure sore was cover with granulation tissues.

Ayurvedic Management of Dushtavrana (Non-Healing Ulcer)– A Case Report

Treatment of non-healing ulcers (dushtaVrana) is a clinical challenge. Even though contemporary medicine can manage infected wounds through antibiotics, non-healing wounds are still a problem to be solved. Ayurveda contributes significantly in the management of dushtavrana through its holistic approach. This case report discusses a 52-year-old male patient who complained of a non-healing ulcer over the left big toe's metatarsophalangeal joint area for six months. With associate complains of pricking pain and itching in the nearby area of the ulcer. Cleaning of the ulcer was done with Nomura arka (Distillation preparation of cow urine) followed by Dhara (wash) with kwatha prepared out of lodhra(SymplocosracemosaRoxb), yashtimadhu (Glycyrrhizaglabra), manjishta (Rubiacordifolia).Sadhyovirechana (Purgation therapy) is performed with trivrutlehua and milk. Orally Aragwadhadikashaya, Sarivadhyasava, and Guggulupanchapalachurna were administered. After 15 days of treatment, there was considerable relief in the pain, and the wound started healing. One month of treatment led to the complete healing of the wound. Parisheka of lodra, yashtimadhu, and manjishtakwatha helps clean and heal the wound due to its vranahara, sandhaneeyaaction. Virechana with Trivrutlehya helps in the elimination of vitiated pitta, which allows for enhancing wound healing. Aragwadhadikashayam helps in dushtaVranashodhana and reduces the itching.Sarivadhyasavaisamapachaka, pittahara and pidakahara.GuggulupanchapalachurnacontainsGuggulu, Pippali, Triphala, etc. as its contents. Hence it contributes to the management of pain and healing of the ulcer.

Intact Fish Skin Graft vs. Standard of Care in Patients with Neuroischaemic Diabetic Foot Ulcers (KereFish Study): An International, Multicentre, Double-Blind, Randomised, Controlled Trial Study Design and Rationale.

Cell and/or tissue-based wound care products have slowly advanced in the treatment of non-healing ulcers, however, few studies have evaluated the effectiveness of these devices in the management of severe diabetic foot ulcers. This study (KereFish) is part of a multi-national, multi-centre, randomised, controlled clinical investigation (Odin) with patients suffering from deep diabetic wounds, allowing peripheral artery disease as evaluated by an ankle brachial index equal or higher than 0.6. The study has parallel treatment groups: Group 1 treatment with Kerecis® Omega3 Wound™ versus Group 2 treatment with standard of care. The primary objective is to test the hypothesis that a larger number of severe diabetic ulcers and amputation wounds, including those with moderate arterial disease, will heal in 16 weeks when treated with Kerecis® Omega3 Wound™ than with standard of care. This study has received the ethics committee approval of each participating country. Inclusion of participants began in March 2020 and ended in July 2022. The first results will be presented in March 2023. The study is registered in ClinicalTrials.gov as Identifier: NCT04537520.

A-Heal® in the Management of Chronic Nonhealing Ulcers

Background and Objective: The aim of this study is to assess the efficacy of A-Heal® in the treatment of nonhealing ulcers (NHU). Patients and Methods: This is a case–control study involving 12 patients who applied A-Heal® 10 mg twice a day on an NHU till the complete healing of the ulcer. The control group had the standard treatment. A-Heal® is a 13 amino acid chain, which was initially isolated from the human placenta, is now synthesized, and has shown to be a powerful angiogenesis factor. Before starting the trial, morphologic features of the ulcers were noted including, size, shape, location, and associated diseases. The follow-up period was set at 6 months. Results: The average age of the treated patients was 52.5 ± 5.3 years in the study group and 51.9 ± 4.7 years in the control group. The mean duration of the ulcer was 13.7 ± 5.3 weeks. All the ulcers were located in the lower limbs. In 9 (75%) patients, there was total healing of ulcers in 22 days and three patients showed signs of wound healing with a reduction in wound size and required an additional 1 week for total healing of the ulcer. Regarding the secondary outcomes of preliminary efficacy, total healing and significant reduction of the area were observed in all patients. There were no adverse events recorded. Conclusion: This case series shows that A-Heal® has proved to be safe with a good preliminary efficacy to heal NHUs, according to the protocol and doses used. A larger clinical trial is needed to verify our results.

A clinical study on efficacy of peri-lesional autologous platelet-rich plasma in non-healing ulcers

Background: Non-healing ulcers are a major health problem worldwide and have a great impact at personal, professional, and social levels. They are a major cause of non-traumatic lower limb amputations. The application of autologous Platelet Rich Plasma (PRP) has been a breakthrough in the treatment of non-healing ulcers, as it is an easy and cost-effective procedure, and provides the necessary growth factors that enhance tissue healing. The aim and objective of the study was to test the effectiveness of peri-ulcer autologous platelet-rich plasma injection in chronic non-healing ulcers and to assess the time taken for wound closure.Methods: This study was conducted on 50 patients during the period of November 2020 to October 2021 from the in-patients of the surgical unit in Dr. PSIMS and RF. Autologous PRP was prepared from whole blood utilizing a rapid, point-of-care system that works on the principle of density gradient centrifugation. Fifty (50) patients with non-healing ulcers of different etiologies, who met the inclusion criteria, were treated with peri-ulcer autologous PRP injections once weekly.Results: Of the 50 cases 29 were male and 21 were female, the mean age of the patients is 54.48±10.79 years. All the patients showed signs of wound healing with a reduction in wound size, and the mean time duration of ulcer healing was 6.75±1.47 weeks.Conclusions: This prospective study has demonstrated the potential safety and efficacy of autologous platelet-rich plasma injection for the treatment of chronic non-healing ulcers.

Platelet-rich Fibrin in Nonhealing Leg Ulcers: A Simple and Effective Therapeutic Option.

Background:Nonhealing ulcers can occur due to a variety of causes and are associated with high morbidity, expensive, and prolonged treatment. We conducted this study to determine the efficacy of autologous platelet-rich fibrin (PRF) in nonhealing ulcers in various disorders, which is a very cost-effective and safe treatment option.Materials and Methods:Eighteen patients with nonhealing leg ulcers were included. The ulcers were treated with PRF at weekly intervals. The response to treatment was recorded by calculating the area of ulcer at baseline and at every subsequent visit till the ulcers healed.Results:The study included 18 patients of nonhealing leg ulcers due to leprosy (n = 6), neuropathic ulcer (n = 4), venous ulcer (n = 3), diabetic foot ulcer (n = 2), post-traumatic ulcer (n = 2), and post-full-thickness skin graft ulcer (n = 1). The mean size of the ulcers was 8.44 cm2 and mean duration was 5.55 months. The mean age of the patients was 40.5 years. The minimum and the maximum sittings required were three and nine, respectively (mean 5). No adverse events were noted.Conclusion:The treatment of nonhealing ulcer with PRF is an easy, safe, simple, and cost-effective method.

A Comparative Study on Therapeutic Efficacy of Autologous Platelet Rich Fibrin Matrix Versus Zinc Oxide And Phenytoin Paste in Non Healing Ulcers.

Context:A non-healing ulcer occurs due to multiple causes and possesses a great impact on the quality of life. Autologous platelet-rich fibrin and the application of a triple combination paste (zinc oxide, phenytoin, and mupirocin ointment) have emerged with a good response in the treatment of non-healing ulcers.Aims:To compare the therapeutic efficacy of autologous platelet-rich fibrin matrix versus the triple combination paste (zinc oxide, phenytoin, and mupirocin ointment) in non-healing ulcers.Settings and Design:Hospital-based interventional comparative study.Materials and Method:Twenty-four patients with non-healing ulcers were randomly divided into two groups. One group received platelet-rich fibrin (PRF) therapy every week for up to 5 weeks and the second group applied triple combination paste (zinc oxide, phenytoin, and mupirocin ointment) again for 5 weeks. In the end, the ulcer area was measured.Statistical Analysis Used:Student's paired t-test was used to evaluate the correlations between variables. A P-value of < 0.05 was considered significant.Results:Group A showed a mean reduction in the ulcer area by 8.26 mm2 (75.99%). Group B showed a mean reduction in the ulcer area by 4.799 mm2 (47.75%), which was statistically significant with a P-value of 0.004.Conclusion:We conclude that autologous platelet-rich fibrin matrix is much more effective than the triple combination paste (zinc oxide, phenytoin, and mupirocin ointment) in the treatment of non-healing ulcers.

To Evaluate the Efficacy and Safety of Autologous Platelet Rich Fibrin Matrix in the Treatment of Non-Healing Ulcer of Various Aetiology

To Evaluate the Efficacy and Safety of Autologous Platelet Rich Fibrin Matrix in the Treatment of Non-Healing Ulcer of Various Aetiology

Platelet-rich fibrin for the treatment of nonhealing ulcers

Platelet-rich fibrin for the treatment of nonhealing ulcers

Treatment of Nonhealing Ulcers with an Allograft/Xenograft Substitute: A Case Series.

ABSTRACTOBJECTIVE:Wound dressings that use biosynthetic cellulose may be a good alternative to dressings currently used to treat chronic and acute ulcers because their nanostructure is similar to collagen. The objective of this study was to evaluate a wound dressing created with a new material that is composed of a fibrillary network of biosynthetic cellulose.METHODS:A case series of 8 patients in primary healthcare centers in Östergötland county council, Sweden, with chronic and acute lower limb wounds were treated with a wound dressing based on eiratex (S2Medical AB, Linköping, Sweden). The dressing was applied to traumatic (n = 5) and venous ulcers (n = 3). All ulcers were considered healed at the end of the treatment.MAIN OUTCOME MEASURE:The wounds were examined at regular intervals by a physician to determine healing time, number of dressing changes, and number of visits.MAIN RESULTS:Mean healing time was 43 ± 6 days after the first application of the dressing. The mean number of visits was 5.7 ± 0.6, and the mean number of dressings used per patient was 1.7 ± 0.2.CONCLUSIONS:These results demonstrate the efficacy of a wound dressing made of eiratex to heal chronic and acute ulcers. The data show that the number of dressings used and dressing changes needed to heal the ulcers are lower than what have been reported in the literature for other dressing materials.

The Use of Cryopreserved Autologous Mononuclear Bone Marrow Cells for the Treatment of Non-Healing Ulcers in Diabetic Foot Syndrome

The Use of Cryopreserved Autologous Mononuclear Bone Marrow Cells for the Treatment of Non-Healing Ulcers in Diabetic Foot Syndrome

Electrical stimulation-induced bullous formation in a pemphigoid diabetic patient: a case report

In 2002, the use of electrical stimulation was approved as an adjuvant treatment for non-healing ulcers. A 50-year-old man with type 2 diabetes of 3 years’ duration was referred to our diabetic foot clinic. The patient was a known case of bullous pemphigoid (BP) for the past 15 years and was under steroid therapy (20 mg/day Prednisolone). Electrical stimulation was used as one of the ancillary methods for the treatment of his chronic diabetic foot ulcers. After two sessions, physical examination revealed a bullous eruption (approximately 14 cm) on an erythematous base in the right leg. The literature is devoid of any case of bullous induced by electrical stimulation in pemphigoid diabetic patients. Further studies are required to validate our observation and fully explain the pathogenesis.

English

AIM: To compare the efficacy of calcium alginate dressings with betadine dressings in the management of non-malignant non-healing ulcers MATERIALS AND METHODS: The study was conducted on 60 patients with non-malignant non-healing ulcers in M.S. Ramaiah Medical Teaching Hospital between June 2nd 2008 and July 31st 2010. They were randomly divided into groups of 30. History was taken and relevant investigations done to rule out any focus of infection. All 60 patients were followed up for 6 months. Patients were assessed on many factors like size of ulcer, site, culture sensitivity of swab, co-morbidities. RESULT: There was similar improvement in both study groups with no complications in either. All parameters were comparable. CONCLUSION: Silver and calcium alginate wound dressings though more expensive have comparable efficacy compared to simple betadine dressings in the treatment of non-healing ulcers

Riboflavin-UVA Treatment for Nonhealing Ulcers of the Cornea

Riboflavin-UVA Treatment for Nonhealing Ulcers of the Cornea

Treatment of nonhealing ulcers with allografts

Chronic wounds often represent a significant medical and economic challenge. Clinicians seek novel therapies poised to foster production of granulation tissue and subsequent healing. Cadaveric allograft remains the mainstay in burn therapy. Research, however, shows that this treatment functions adjunctively in complex nonhealing wounds by manipulating the microenvironment, preventing desiccation of underlying bone and tendon, augmenting wound-bed preparation, and producing rapid closure. The following review presents the rationale for incorporating skin allografts into the wound healing algorithm, including chronic wound biochemistry, wound-bed preparation, current applications, combination therapies, cost considerations, and case studies. Diagnosis and treatment of underlying etiologies remains essential. A multidisciplinary approach using accepted treatment protocols helps reduce morbidity and expense associated with these lesions.