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. 2021 Feb 5:76:e2355.
doi: 10.6061/clinics/2021/e2355. eCollection 2021.

Efficacy of autologous platelet-rich plasma gel in the treatment of refractory pressure injuries and its effect on wound healing time and patient quality of life

Qian Liu  1 , Ning Zhang  2 , Zhengnan Li  1 , Hongmei He  2
Affiliations

Efficacy of autologous platelet-rich plasma gel in the treatment of refractory pressure injuries and its effect on wound healing time and patient quality of life

Qian Liu et al. Clinics (Sao Paulo). .

Abstract

Objectives: To evaluate the efficacy of autologous platelet-rich plasma (PRP) gel in the treatment of refractory pressure injuries and its effect on wound healing time and quality of life of patients.

Methods: A random number table method was used to group 102 patients with refractory pressure injuries into either a control group (CG) (51 cases) receiving negative pressure wound therapy (NPWT) or a study group (SG) (51 cases) receiving NPWT+PRP gel.

Results: The total efficacy rate in the SG (92.16%) was higher than that in the CG (76.47%) (p<0.05). The SG exhibited lower visual analog scale (VAS) scores and pressure ulcer scale for healing (PUSH) scores, smaller wound sizes and depths, and shorter wound healing times than the CG after 21 days of treatment (p<0.05). After 6 months of treatment, the SG scored higher than the CG on the psychological, physiological, social functions, and daily activity domains on the World Health Organization Quality of Life (WHOQOL-BREF) scale (p<0.05). The incidence of postoperative complications in the SG (13.73%) was not significantly different from that of the CG (7.84%) (p>0.05).

Conclusion: In the treatment of refractory pressure injuries, PRP gel can accelerate wound healing, reduce wound pain, shorten the treatment cycle, regulate tissue inhibitor matrix metalloproteinase-1 (TIMP-1) and matrix metalloproteinase-9 (MMP-9) levels and the expression of specific proteins in granulation tissue, reduce the levels of the inflammatory factors interleukin-1β (IL-1β), IL-8, and tumor necrosis factor-α (TNF-α), and improve the quality of life of patients without increasing complications.

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Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1. Comparison of wound healing indices between the two groups. A: VAS score, B: PUSH score, C: wound healing time. *** indicates p<0.001 when compared to levels before treatment; ### indicates p<0.001 when compared to the control group. VAS: Visual analog scale; PUSH: Pressure Ulcer Scale for Healing.
Figure 2
Figure 2. Comparison of wound size and depth between the two groups. A: Wound size, B: Wound depth. *** indicates p<0.001 when compared to levels before treatment; ### indicates p<0.001 when compared to the control group.
Figure 3
Figure 3. Comparison of granulation tissue-specific protein expression. A: VEGF levels, B: SDF-1α levels, and C: CXCR4 levels. *** indicates p<0.001 when compared to levels before treatment; ### indicates p<0.001 when compared to the control group. VEGF, vascular endothelial growth factor; SDF-1a, stromal cell-derived factor-1α; CXCR4, chemokine receptor 4.
Figure 4
Figure 4. Comparison of the levels of inflammatory markers. A: IL-1β levels; B: IL-8 levels; C: TNF-α levels. *** indicates p<0.001 when compared to levels before treatment; ### indicates p<0.001 when compared to the control group. IL-1β: Interleukin-1β; TNF-α: Tumor necrosis factor-α.
Figure 5
Figure 5. Comparison of TIMP-1 and MMP-9 levels. A: TIMP-1 levels and B: MMP-9 levels. *** indicates p<0.001 when compared to levels before treatment; ### indicates p<0.001 when compared to the control group. TIMP-1: matrix metalloproteinase inhibitor-1; MMP-9: matrix metalloproteinase-9.
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