Healing of a Large Wound Defect Post Debridement, with PRF Therapy and High Dose Oral Vitamin C, in a Patient of Severe Irritant Contact Dermatitis Due to Slaked Lime: A Case Report

Abstract

Platelet-rich blood concentrates have been used to accelerate healing process in wounds and in bones since many decades worldwide. Platelet-rich fibrin (PRF) is a relatively new and established therapy, utilizing platelets and leucocytes trapped in fibrin matrix, for the treatment of non-healing ulcers and wounds. Many large series are available in this subject to prove its efficacy. Our patient, a known case of eczema, had applied slaked lime (calcium hydroxide) over an eczematous lesion on right leg and surrounding area, after which he developed deep wound with extensive erythema and blisters initially, which healed with necrosis due to patient's neglect, in about 2 weeks. On presentation to us, the lesion had undergone necrosis and hence decision to debride the lesion was taken. After debridement, a large defect was created, which we tried treating conservatively using PRF therapy primarily, followed by pressure dressing. High dose vitamin C was given orally. The patient required antibiotics intermittently. The patient responded well to this protocol and the wound defect was closed within a few weeks.

Keywords: Debridement; PRF therapy; vitamin C; wound healing.

Figure 1

At presentation. Large lesion with overlying crust

Figure 2

Immediately after debridement. A large wound defect is seen

Figure 3

One week after debridement. Stable wound without oozing

Figure 4

Weeks 2 and 3. Progression of healing

Figure 5

Weeks 4 and 5 after therapy. Visible reduction of defect

Figure 6

Weeks 6–8: progressive healing

Figure 7

Week 9, wound almost healed

Figure 8

Week 10, defect closed