Abstract :
Introduction: The therapeutic use of autologous platelet concentrates represents a newer regenerative avenue to stimulate and accelerate complex wound healing. These non-healing ulcers have repercussions in terms of decrease functional outcome and productivity of the patients. Here, we intend to wider the horizon of an alternative approach for treating small-to-moderate-sized complex wounds of lower extremities by using novel Leucocyte Platelet-Rich Fibrin (L-PRF) which embraces healing potentiality over that of bare soft tissue, including bone, tendon, and ligaments respectively.
Materials and Methods: A total of 23 cases of non-healing ulcers were receiving L-PRF gel application. The cases with small and large ulcers received L-PRF gel weekly once for 3 and 6 weeks respectively. All the cases were followed up in regular intervals at the end of every week and the end of 3rd month. To document the progress of ulcer healing, we calculated the area and volume of the ulcer at the beginning of the procedure and every week till the size of the ulcer gets contracted. Photographic documentation was performed for all the cases.
Results: The duration of non-healing ulcers ranged from 6 months to 24 months with a mean duration of 15.05 2.37 months. According toWagner’s ulcer classification scale, 15 ulcers (65.21%) belong to grade 1 and 8 ulcers (34.78%) belong to grade 2. In grade 1 ulcer cases, the mean area and volume improvement observed was 100% at the end of 3 months whereas, in grade 2 ulcer cases, the mean area and volume improvement observed was 95.67% and 97.31% at the end of 3 months. The volume of 15 ml of venous blood was sufficient to cover an ulcer with a maximum area of 23.12 cm2 with 1 mm thickness of L-PRF.
Conclusion: Our study adds to the string of positive evidence for treating complex wounds using L-PRF wherein this autologous preparation is available at greater ease to facilitate the process of granulation tissue formation and epithelization. This serves as a good alternative to manage wounds of small to medium size and minimizes the need to plan for relevant soft tissue surgeries.
Keyword :
NonHealing ulcer, Platelet Rich Fibrin, Regenerative Medicine.