A case series of platelet rich plasma in chronic venous ulcers

Abstract

Introduction: Venous ulcers are the most common type of leg wounds (80%) and the main cause is chronic venous insufficiency. Autologous platelet-rich plasma (PRP) is a potential wound healing treatment due to its great variety of growth factors. The aim of this study was to describe in a case series the results of poor-leukocyte PRP (P-PRP) or saline for the treatment of chronic non-healing ulcers of the lower extremity.

Methods: Eight patients were treated according to the topical therapy: saline solution or P-PRP gel. All patients used double compression stocks and were assisted by a vascular practitioner for up to 12 months or until wound healing. The treatment was performed weekly with cleaning of the affected area, macroscopic evaluation (area measurement and photos) and P-PRP or saline application, and closure with Tegaderm®. Trial Registration: Retrospectively approved by Brazilian Clinical Trials, register number RBR-7zhgb3 (http://www.ensaiosclinicos.gov.br/rg/RBR-7zhgb3/).

Results: All patients showed signs of wound healing with a reduction in wound size and ulcer numbers, but more evident with P-PRP application.

Conclusions: The results suggested that P-PRP presented a better result when compared to saline solution in the healing process of long clinical course chronic venous ulcers, when associated to compressive stocks and topical care.

Keywords: Chronic venous ulcer; Healing; Platelet rich plasma; Wounds.

Fig. 1

Median area of wounds over time (12 months).

Fig. 2

Number of wounds at initial time (T = 0) and until final time (T-end).

Fig. 3

Patient 1 before and after PRP treatment. Patient's wound progress, area in cm² versus time (left) and wound progress at initial time and after 12 months (Right).

Fig. 4

Patient 3 before and after PRP treatment. Patient's wound progress, area in cm²versus time (left) and wound progress at initial time and after 5 months (Right).

Fig. 5

Patient 5 before and after saline solution treatment. Patient's wound progress, area in cm² versus time (left) and wound progress at initial time and after 9 months (Right).

Fig. 6

Patient 7 before and after saline treatment. Patient's wound progress, area in cm²versus time (left) and wound progress at initial time and after 11 months (Right).