Study of Efficacy of Autologous Platelet Rich Fibrin Versus Platelet Rich Plasma as a Regenerative Medicine Strategy For Chronic Cutaneous Ulcers.

Abstract

Management of non-healing ulcers is a major challenge clinically. Current therapies include debridement, offloading etc. which show poor response. Newer modalities include stem cells, platelet derived growth factors and fibrin glues which reduce the healing time of chronic wounds. Platelets have a major role in wound healing through the secretion of growth factors, chemokines etc. Aims & Objective To study the comparative efficacy of autologous Platelet Rich Fibrin (PRF) versus Platelet Rich Plasma (PRP) as a regenerative medicine strategy for chronic cutaneous ulcers. Materials & Methods Patients with ulcers of duration >6 weeks were enrolled for a comparative study comprising of two groups. A total of 42 cases of chronic cutaneous ulcers were evaluated in the study. The 42 ulcer cases were divided into group A receiving weekly PRF dressings and group B receiving weekly PRP dressing for a maximum of 6 weeks. Ulcer evaluation was performed at baseline, each weekly dressing and at 2 week follow-up post final procedure. Results Primary efficacy was assessed by percentage reduction of ulcer size and patients with 100% re-epithelization at 8 weeks. 95.2% of ulcers in Group A and 90.4% ulcers in Group B showed complete re-epithelization. One ulcer in group A and two ulcers in group B showed development of infections during procedure, hence procedure had to be abandoned. The ulcers developing infection were also associated with pain and sero-purulent discharge. Recurrence of ulcer was seen in 4 ulcers in PRF group and 3 ulcers in PRP group, however these did not occur during the duration of follow-up. 9 DocuSign Envelope ID: 253BDAB6C4B7621--84EB3347--447F9AA7-A-96A6FB1--2B687229C189716AE0FCBF94 Conclusion Dressings done with platelet rich fibrin (PRF) and platelet rich plasma (PRP) showed similar efficacy in percentage reduction in volume of ulcer and re-epithelization of chronic cutaneous ulcers. Both forms of dressings were associated with similar complications of infection and recurrence. PRF and PRP dressings provide a safe, efficacious and inexpensive regenerative medicine strategy in the healing of chronic cutaneous ulcers.