Utilization of Platelet Rich Plasma Reconstituted with Ascorbic Acid (Vitamin C) to Treat Hard to Heal Wounds in Patients with Diabetes.

Introduction: The problem that was addressed by our wound clinic was that we had hard to heal chronic wounds that had been present often times for greater than 6 months in patients with diabetes. Diabetic patients often times have wounds that are hard to heal, one of the reasons is due to a deficiency in Vitamin C.Methods: In order to solve the problem of hard to heal wounds in patients with diabetes a platelet rich plasma system was used that also included reconstitution with Vitamin C. This allowed for topical application of not only platelet rich plasma, but also re-introduced Vitamin C into the wound bed to help aid in patient healing.Results:What was found through the utilization of a platelet rich plasma system that also integrates Vitamin C into the wound bed is that we could often times get wounds to heal at a much quicker rate, jump starting old wounds that had been present for long periods of time. We found that depth improved rapidly and significantly and that size was decreased with as little as 1 or 2 applications. One patient example is of a Chronic wound that had been treated for 7 months with little progress. After 1 application of the PRP with Ascorbic Acid reconstitution the wound reduced by 93% and achieved closure with only 3 applications over the course of 3 weeks. Another patient who had a wound for 4 months with little progression healed by 26% (started at 32 sq cm) after 1 application and achieved complete closure after only 6 applications in as many weeks. A third example is a patient who had a stalled wound for 8 months, and after just  1 application had a reduction in size of 71%.Discussion: What we learned from this experience is that utilizing the patients own blood and using centrifugation to separate the platelets and reconstitute them with Ascorbic Acid (Vitamin C) was able to jump start wounds that had been stalled for a significant period of time and showed large reduction in size after very few applications and often progressed to closure quickly. Continued utilization of Platelet Rich Plasma and Ascorbic Acid has yielded similar results in the majority of patients we have utilized this therapy on.References:Haubner, F., Ohmann, E., Pohl, F. et al. Wound healing after radiation therapy: Review of the literature. Radiat Oncol 7, 162 (2012). https://doi.org/10.1186/1748-717X-7-16