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Platelet Rich Plasma (PRP) for Treatment of Chronic Non Healing Ulcer

During my residency, I was regularly posted in the Blood Bank for my thesis project. My mentor, Dr. Dharmesh Chandra Sharma (retd. Blood bank in-charge), along with the thesis work also included me in a lot of fine research projects which he used to conduct in the blood bank.

Hereby, I am discussing one of the case projects we did together.

A wound refers to a sharp injury which damages the dermis of the skin. Wounds that have impaired healing process enter a state of pathological inflammation. Non-healing wounds result in enormous expenditures in healthcare. Chronic wounds are of various types such as venous leg ulcers, ischemic wounds, diabetic foot ulcers, ischemic wounds and pressure wounds (bed sores/ pressure ulcers).

Bed sores/pressure ulcers are a very common problem in bed ridden patients. Some patients develop resistance to the antibiotics resulting in progression of the ulcer to higher grades which might lead to tissue necrosis, damage to bones, joints and even life threatening infections.

Presently, for pressure ulcers standard treatment of choice is pressure relief, surgical debridement and treatment with local and systemic antibiotics. In this case study we used PRP dressing for the treatment of chronic non healing ulcer (bed sore/ pressure ulcer).

Platelet rich plasma (PRP) also called as autologous platelet gel is rich in growth factors. It is essentially an increased concentration of autologous platelets suspended in small amount of plasma after centrifugation.

Platelets help in hemostasis and consist of growth factors stored in α- granules. These are platelet derived growth factor (PDGF), insulin like growth factor (IGF), vascular endothelial growth factor (VEGF), platelet derived angiogenic factor (PDAF) and transforming growth factor -beta (TGF-β).

Growth factors are involved in key stages of wound healing and regenerative process including chemotaxis, proliferation, differentiation and angiogenesis. Along with these growth factors platelets also release fibronectin, vitronectin, sphingosine 1 phosphate etc. which promotes wound healing.

Our case study was a 22 years old male having lower limb paresis. He was suffering from non-healing wound on left buttock as he got bed ridden after a prior surgery which was not responding to conventional treatments with local and systemic antibiotics. Dermatology consultation and guidance was taken for in depth approach of the patient from a renowned dermatologist Dr. Khozema Saify. At the time of presentation the ulcer was 5x4 cm in size and 1.5 cm in depth.

For PRP dressing the wound was cleaned thoroughly with spirit and local dressing with platelet rich plasma was applied to the patient every alternate day for one month. For each dressing fresh pad of PRP was used and was kept on the wound for 30 minutes till it got absorbed.  

Then, it was covered with perforated glacial paper and pressure dressing was done using cotton and bandage. No local or systemic antibiotic was given to the patient during the treatment.

After 15 dressings the wound was completely healed. Hence, PRP dressing proved beneficial in prevention of further complications and infection in the patient.

This way of treatment has been mentioned in literature as well as by few clinicians.  

This case report co-authored by me has already been published in a journal in 2016.

This is my personal blog hence I've not put any references here but if any one wants to visit the link to the original case report do leave a comment below.

I decided to share about PRP due to it's increasing demand in healthcare as well as skincare industry. 

All the procedures were done with consultation and under supervision of experienced doctors. 

Take care 🙂

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