Poster

Treatment of Chronic Lower Extremity Wounds with High Concentrate Platelet-Rich Plasma

Alisha Oropallo, Amit Rao, Sally Kaplan, Jeffrey Nicastro, Gene Coppa, Russell Caprioli, John Haight, Michael Pliskin, Raymond Ferguson

Presented at Symposium on Advanced Wound Care Spring 2018

Background: Autologous platelet-rich plasma (PRP) is a potential wound healing treatment for chronic wounds.

Purpose: The purpose of this trial was to look at the effect of PRP on reducing the size of a chronic wound, increasing the velocity of healing (wound closure), improving health outcomes (quality of life), and eliminating recurrence of a chronic wound after healing.

Methods: Ten patients aged 48-89 with chronic lower extremity wounds of median wound duration of 421 days (53-1,264 days) and median size 27.6 cm2 (1.5-115 cm²) were treated with autologous PRP. PRP was extracted using a centrifuge. This system allows for the formation of reproducible, concentrated PRP with limited amounts of patient whole blood. Standard treatment was determined to be 1mL/4cm² of wound surface area. PRP was combined with CaCl and thrombin to create a gel-like substance.

Results: Eight participants exhibited signs of accelerated healing, with marked decrease in depth. Two patients withdrew from the study after one treatment. Three patients treated with higher than standard concentrate (>1mL/4cm²) autologous PRP healed completely. Of the patients who saw complete closure, each had a different wound etiology; diabetic foot ulcer, venous ulcer or pressure ulcer that was on average 103 days old and 5.5 cm² at initial visit. Complete wound closure took an average of 14 weeks to occur with subjects undergoing 5-6 PRP treatments during that time. The remaining wounds had a 63.43% reduction in surface area. These wounds were treated with exact or less than standard concentrations (≤1mL/4cm2) of PRP. No serious adverse reactions involving PRP were observed during the study.

Conclusion: Subjects treated with higher than standard PRP concentration exhibited the greatest healing. Results support the use of autologous PRP to treat chronic lower extremity wounds, notably, high concentrate PRP. Further studies should include larger sample sizes and randomized control trials.