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.
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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.
