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Published in: World Journal of Surgery 4/2020

01-04-2020 | Diabetic Foot | Original Scientific Report

Randomized Controlled Trial on Autologous Platelet-Rich Plasma Versus Saline Dressing in Treatment of Non-healing Diabetic Foot Ulcers

Authors: Ahmed Elsaid, Mohammed El-Said, Sameh Emile, Mohamed Youssef, Wael Khafagy, Ayman Elshobaky

Published in: World Journal of Surgery | Issue 4/2020

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Abstract

Background

This randomized clinical trial was conducted to assess the role of platelet-rich plasma (PRP) gel as a treatment of clean non-healing diabetic foot ulcer (DFU) in comparison with regular dressing with saline as a control.

Methods

Patients with DFU were randomly assigned to one of two equal groups: group I received dressing with PRP gel and group II received regular saline dressing. The main outcomes of the study were percent reduction in the dimensions of the DFU, healing of DFU, and complications at 20 weeks of follow-up.

Results

Twenty-four patients were included to the study. The mean age of patients was 55.2 ± 6.4 years. Only three (25%) patients in group I achieved complete healing versus none of group II patients. In total, 8.3% of group I and 41.6% of group II patients did not show any response to treatment. The percent of reduction in the longitudinal and horizontal dimensions of the DFU was significantly greater in group I than group II (43.2% vs 4.1%) and (42.3% vs 8.2%), respectively. The time required to maximum healing was significantly shorter in group I than group II (6.3 ± 2.1 vs 10.4 ± 1.7 weeks, P < 0.0001).

Conclusion

The use of PRP gel as a dressing for chronic DFU resulted in a more significant reduction in the size of the ulcer when compared to regular saline dressing. Also the time to reach the point of maximal possible healing with the least wound dimensions was significantly shorter when using PRP as a dressing protocol.
Literature
1.
go back to reference Abbott CA, Carrington AL, Ashe H, Bath S, Every LC, Griffiths J, Ryder CH (2002) The north-west diabetes foot care study: incidence of and risk factors for new diabetic foot ulceration in a community-based patient cohort. Diabet Med 19(5):377–384CrossRef Abbott CA, Carrington AL, Ashe H, Bath S, Every LC, Griffiths J, Ryder CH (2002) The north-west diabetes foot care study: incidence of and risk factors for new diabetic foot ulceration in a community-based patient cohort. Diabet Med 19(5):377–384CrossRef
2.
go back to reference Alexiadou K, Doupis J (2012) Management of diabetic foot ulcers. Diabetes Therapy 3(1):4CrossRef Alexiadou K, Doupis J (2012) Management of diabetic foot ulcers. Diabetes Therapy 3(1):4CrossRef
3.
go back to reference Prompers L, Schaper N, Apelqvist J, Edmonds M, Jude E, Mauricio D, Jirkovska A (2008) Prediction of outcome in individuals with diabetic foot ulcers: focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE study. Diabetologia 51(5):747–755CrossRef Prompers L, Schaper N, Apelqvist J, Edmonds M, Jude E, Mauricio D, Jirkovska A (2008) Prediction of outcome in individuals with diabetic foot ulcers: focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE study. Diabetologia 51(5):747–755CrossRef
4.
go back to reference Marx RE (2004) Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg 62(4):489–496CrossRef Marx RE (2004) Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg 62(4):489–496CrossRef
5.
go back to reference Cancela AM, Lana JF, Annichino-Bizzachi JM, Belangero WD, Luzo ÂC (2014) Use of platelet-rich plasma (PRP) in treating chronic wounds. In: Lana JF, Shimojo AA, Belangero WD, Malheiros Luzo AC (eds) Platelet-rich plasma. Springer, Berlin, pp 281–288CrossRef Cancela AM, Lana JF, Annichino-Bizzachi JM, Belangero WD, Luzo ÂC (2014) Use of platelet-rich plasma (PRP) in treating chronic wounds. In: Lana JF, Shimojo AA, Belangero WD, Malheiros Luzo AC (eds) Platelet-rich plasma. Springer, Berlin, pp 281–288CrossRef
6.
go back to reference Motolese A, Vignati F, Antelmi A, Saturni V (2015) Effectiveness of platelet-rich plasma in healing necrobiosis lipoidica diabeticorum ulcers. Clin Exp Dermatol 40(1):39–41CrossRef Motolese A, Vignati F, Antelmi A, Saturni V (2015) Effectiveness of platelet-rich plasma in healing necrobiosis lipoidica diabeticorum ulcers. Clin Exp Dermatol 40(1):39–41CrossRef
7.
go back to reference Shan GQ, Zhang YN, Ma J, Li YH, Zuo DM, Qiu JL, Chen ZL (2013) Evaluation of the effects of homologous platelet gel on healing lower extremity wounds in patients with diabetes. Int J Low Extrem Wounds 12(1):22–29CrossRef Shan GQ, Zhang YN, Ma J, Li YH, Zuo DM, Qiu JL, Chen ZL (2013) Evaluation of the effects of homologous platelet gel on healing lower extremity wounds in patients with diabetes. Int J Low Extrem Wounds 12(1):22–29CrossRef
8.
go back to reference Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Cenacchi A, Marcacci M (2010) Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 18(4):472–479CrossRef Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Cenacchi A, Marcacci M (2010) Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 18(4):472–479CrossRef
9.
go back to reference Ahmed M, Reffat SA, Hassan A, Eskander F (2017) Platelet-rich plasma for the treatment of clean diabetic foot ulcers. Ann Vasc Surg 38:206–211CrossRef Ahmed M, Reffat SA, Hassan A, Eskander F (2017) Platelet-rich plasma for the treatment of clean diabetic foot ulcers. Ann Vasc Surg 38:206–211CrossRef
10.
go back to reference Saldalamacchia G, Lapice E, Cuomo V, De Feo E, D’Agostino E, Rivellese AA, Vaccaro O (2004) A controlled study of the use of autologous platelet gel for the treatment of diabetic foot ulcers. Nutr Metab Cardiovasc Dis 14:395–396CrossRef Saldalamacchia G, Lapice E, Cuomo V, De Feo E, D’Agostino E, Rivellese AA, Vaccaro O (2004) A controlled study of the use of autologous platelet gel for the treatment of diabetic foot ulcers. Nutr Metab Cardiovasc Dis 14:395–396CrossRef
11.
go back to reference Margolis DJ, Kantor J, Santanna J, Strom BL, Berlin JA (2001) Effectiveness of platelet releasate for the treatment of diabetic neuropathic foot ulcers. Diabet Care 24(3):483–488CrossRef Margolis DJ, Kantor J, Santanna J, Strom BL, Berlin JA (2001) Effectiveness of platelet releasate for the treatment of diabetic neuropathic foot ulcers. Diabet Care 24(3):483–488CrossRef
12.
go back to reference Abegão KGB, Bracale BN, Delfim IG, Santos ESD, Laposy CB, Nai GA, Nogueira RMB (2015) Effects of heterologous platelet-rich plasma gel on standardized dermal wound healing in rabbits. Acta cirúrgica brasileira 30(3):209–215CrossRef Abegão KGB, Bracale BN, Delfim IG, Santos ESD, Laposy CB, Nai GA, Nogueira RMB (2015) Effects of heterologous platelet-rich plasma gel on standardized dermal wound healing in rabbits. Acta cirúrgica brasileira 30(3):209–215CrossRef
13.
go back to reference Jeong SH, Han SK, Kim WK (2010) Treatment of diabetic foot ulcers using a blood bank platelet concentrate. Plast Reconstr Surg 125(3):944–952CrossRef Jeong SH, Han SK, Kim WK (2010) Treatment of diabetic foot ulcers using a blood bank platelet concentrate. Plast Reconstr Surg 125(3):944–952CrossRef
14.
go back to reference Crovetti G, Martinelli G, Issi M, Barone M, Guizzardi M, Campanati B, Carabelli A (2004) Platelet gel for healing cutaneous chronic wounds. Transfus Apher Sci 30(2):145–151CrossRef Crovetti G, Martinelli G, Issi M, Barone M, Guizzardi M, Campanati B, Carabelli A (2004) Platelet gel for healing cutaneous chronic wounds. Transfus Apher Sci 30(2):145–151CrossRef
15.
go back to reference Driver VR, Hanft J, Fylling CP, Beriou JM (2006) A prospective randomized controlled trial of autologous platelet-rich plasma gel for the treatment of diabetic foot ulcers. Ostomy Wound Manag 52(6):68 Driver VR, Hanft J, Fylling CP, Beriou JM (2006) A prospective randomized controlled trial of autologous platelet-rich plasma gel for the treatment of diabetic foot ulcers. Ostomy Wound Manag 52(6):68
Metadata
Title
Randomized Controlled Trial on Autologous Platelet-Rich Plasma Versus Saline Dressing in Treatment of Non-healing Diabetic Foot Ulcers
Authors
Ahmed Elsaid
Mohammed El-Said
Sameh Emile
Mohamed Youssef
Wael Khafagy
Ayman Elshobaky
Publication date
01-04-2020
Publisher
Springer International Publishing
Keyword
Diabetic Foot
Published in
World Journal of Surgery / Issue 4/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-019-05316-0

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