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PRP Treatment of Diabetic Foot Ulcers

May 11, 2018by Doug Ginter

PRP is a platelet concentrate extracted from whole blood by centrifugal process, containing high concentrations of platelets, leukocytes, and fibrin. It refers to using your own blood to extract plasma rich in high concentrations of platelets and various autologous growth factors. These factors have an extremely important role in promoting the healing of wounds and the proliferation and differentiation of cells and the formation of tissues. One of the most disturbing conditions is diabetic foot ulcers.

Platelet-rich plasma (PRP) is a widespread technique in multiple fields of medicine, with use described in a wide variety of pathologies and clinical situations. Its use in dermatology goes beyond its popular association with facial aging. Given the therapeutic challenge posed by the management of chronic ulcers, it represents an alternative treatment with demonstrated efficacy in vivo and in vitro.

PRP is defined as containing a platelet concentration higher than baseline in peripheral blood. Platelets, in addition to their essential role in the coagulation cascade, store essential proteins in their interior in healing. Plasma also has bioactive molecules that stimulate cell migration, proliferation, differentiation, and metabolism.

Does PRP help in treatment of diabetic foot ulcers

Diabetic patients have been registered to have a reduced growth factor concentration in tissues, particularly epidermal growth factor. This deficiency affects the healing of wounds, leads to their chronic development and the risk of amputation. An ischemic diabetic foot ulcer is the most difficult to treat and is associated with the highest risk of amputation.

Diabetics combined with foot disorders often have clinically difficult treatment. Such patients are prone to bone nonunion or osteoarticular fusion surgery failure, easy to concurrent infection and skin ulcers difficult to heal. Basic research has shown that the concentration of multiple key growth factors in the diabetic foot injury site is significantly reduced. In recent years, it has been found that in patients with diabetes who failed to undergo Charcot joint reconstruction surgery, the levels of PDGF and VEGF in the bone-articular fusion site were significantly lower than those in normal people. PRP contains a variety of growth factors, clinically related to the use of PRP therapy in Charcot joint reconstruction surgery.

In a multicenter, prospective clinical randomized controlled trial, Driver V.R. used autologous PRP gel to treat diabetic foot ulcers. A total of 40 eligible patients were included in the study. They were randomly divided into two groups: the treatment group (n = 19) received topical treatment with PRP gel; the control group (n = 21) received saline gel treatment. Healing of ulcers was evaluated every 2 weeks for a total of 12 weeks. Thirteen (68.4%) and 9 (42.9%) ulcers recovered in the treatment and control groups, respectively. Kaplan-Meier healing time analysis also showed that the PRP treatment group was significantly better than the control group. No serious side effects occurred during PRP treatment. The study concluded that the use of PRP in diabetic foot ulcers is highly effective.

Caution!

Autologous PRP may increase the healing of foot ulcers in patients with diabetes compared to standard care. However, it is not clear whether autologous PRP has an effect on other types of chronic wounds.

To remind diabetic patients, if the diabetic foot is not actively treated to resolve the symptoms and complications of the lower extremities, it will have catastrophic consequences. Therefore, once you develop diabetic foot, you must go to the hospital for timely and systematic treatment. Delaying the timing of the treatment and cause more serious consequences such as amputation. Patients with diabetic foot are welcome to come to our hospital for consultation and treatment. Give us a trust and return your health!

Doug Ginter