BACKGROUND:Diabetic foot ulcer (DFU) is well managed by infection control, euglycemic state, and debridement of the ulcer followed by appropriate dressing and off-loading of the foot. Studies show that approximately 90% of DFUs that are properly off-loaded heal in nearly 6 weeks. Platelet-rich plasma (PRP) serves as a growth factor agonist and has mitogenic and chemotactic properties that help in DFU healing. We sought to evaluate the efficacy of local application of PRP with respect to healing rate and ulcer area reduction in treating DFUs. METHODS:Sixty noninfected patients with DFUs (plantar surface area, ≤20 cm2; Meggitt-Wagner grades 1 and 2) were randomized to receive normal saline dressing (control group [CG]) or PRP dressing (study group [SG]) along with total-contact casting for 6 weeks or until complete ulcer healing, whichever was earlier. Healing rate and change in ulcer area were evaluated weekly. RESULTS:Mean ±SD ulcer area at baseline was 4.96 ± 2.89 cm2 (CG) and 5.22 ± 3.82 cm2 (SG) (P = .77), decreasing to 1.15 ± 1.35 cm2 (CG) and 0.96 ± 1.53 cm2 (SG) (P = .432) at 6 weeks. Mean ± SD percentage reduction in healing area at 6 weeks was 81.72% ± 17.2% (CG) and 85.98% ± 13.42% (SG) (P = .29). Mean ±SD healing rate at 6 weeks was 0.64 ± 0.36 cm2 (CG) and 0.71 ± 0.46 cm2 (SG) (P = .734). CONCLUSIONS: The PRP dressing is no more efficacious than normal saline dressing in the management of DFU in conjunction with total-contact casting.
RCT Entities:
BACKGROUND:Diabetic foot ulcer (DFU) is well managed by infection control, euglycemic state, and debridement of the ulcer followed by appropriate dressing and off-loading of the foot. Studies show that approximately 90% of DFUs that are properly off-loaded heal in nearly 6 weeks. Platelet-rich plasma (PRP) serves as a growth factor agonist and has mitogenic and chemotactic properties that help in DFU healing. We sought to evaluate the efficacy of local application of PRP with respect to healing rate and ulcer area reduction in treating DFUs. METHODS: Sixty noninfected patients with DFUs (plantar surface area, ≤20 cm2; Meggitt-Wagner grades 1 and 2) were randomized to receive normal saline dressing (control group [CG]) or PRP dressing (study group [SG]) along with total-contact casting for 6 weeks or until complete ulcer healing, whichever was earlier. Healing rate and change in ulcer area were evaluated weekly. RESULTS: Mean ± SD ulcer area at baseline was 4.96 ± 2.89 cm2 (CG) and 5.22 ± 3.82 cm2 (SG) (P = .77), decreasing to 1.15 ± 1.35 cm2 (CG) and 0.96 ± 1.53 cm2 (SG) (P = .432) at 6 weeks. Mean ± SD percentage reduction in healing area at 6 weeks was 81.72% ± 17.2% (CG) and 85.98% ± 13.42% (SG) (P = .29). Mean ± SD healing rate at 6 weeks was 0.64 ± 0.36 cm2 (CG) and 0.71 ± 0.46 cm2 (SG) (P = .734). CONCLUSIONS: The PRP dressing is no more efficacious than normal saline dressing in the management of DFU in conjunction with total-contact casting.
Authors: Edilson S Machado; Fabiano P Soares; Roberta S Yamaguchi; William K Felipone; Robert Meves; Tais Amara C Souza; Roberto Topolniak; José P Caldas; Ernani V Abreu; Luiz S Rabelo Neto; Pedro Vinicius S Pinchemel; Markus Bredemeier Journal: Cureus Date: 2022-01-03
Authors: Andreas Kerstan; Kathrin Dieter; Elke Niebergall-Roth; Markus H Frank; Mark A Kluth; Sabrina Klingele; Michael Jünger; Christoph Hasslacher; Georg Daeschlein; Lutz Stemler; Ulrich Meyer-Pannwitt; Kristin Schubert; Gerhard Klausmann; Titus Raab; Matthias Goebeler; Korinna Kraft; Jasmina Esterlechner; Hannes M Schröder; Samar Sadeghi; Seda Ballikaya; Martin Gasser; Ana M Waaga-Gasser; George F Murphy; Dennis P Orgill; Natasha Y Frank; Christoph Ganss; Karin Scharffetter-Kochanek Journal: Stem Cell Res Ther Date: 2022-09-05 Impact factor: 8.079