Platelet-Rich Plasma, Wound Healing Delayed
Conditions
Keywords
Platelet-Rich Plasma, Laser Doppler Imaging, Growth Factors, Wound Healing, Chronic wound healing disorder, Wound quality of life
Brief summary
Chronic soft tissues defects can extend into the fat layer or even deeper and can cause functional disadvantages. Split-thickness skin grafts (STSGs) used to cover these wounds have varying success rates. To improve wound healing in chronic wounds the authors have studied the application of autologous platelet concentrates in a human keratinocyte culture model in vitro and in a combination with surgical procedures in vivo as second line therapy in patients with initially failed wound closure.
Detailed description
For in vitro testing on keratinocytes a platelet-mediator concentrate (PMC) was processed with a commercially available bed-side system (ATR®, Curasan, Germany). In a clinical study soft tissue defects (n=5) were treated using a combination of surgical debridement and autologous platelet rich plasma (PRP). Time of healing as determined by epithelization as well as Laser Doppler Imaging to visualize blood flow were analyzed. Additionally, changes in ease of surgical wound closure were determined. Finally, the quality of life of patients was assessed using a validated questionnaire.
Interventions
COMBINATION_PRODUCTPlatelet-Rich Plasma
Adding PRP to wound bed during surgical debridement
Sponsors
Hannover Medical School
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* exposed tendons, ligaments or bone for \>3 weeks * no healing tendency
Exclusion criteria
* sepsis * intensive care treatment * continuous smoking * pregnancy or breast feeding women * participants of other studies.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Wound Closure | 4 weeks | Area of wound closure in % compared to initial size |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Blood Flow | 4 weeks | Blood flow measured in wound margins and wound bed compared to regular skin measured using Laser Doppler Imaging |
| Wound Quality of Life | 21 days | Quality of patients' life measured using Wound-QoL® Questionnaire before and after Intervention. Seventeen items are included in the Wound-QoL, which could be attributed to three subscales on everyday life, body, and psyche. The paper presents the overall score. A higher value correlates with more wound related burden, meaning a lower value indicates higher qulitiy of life. More information: https://www.ncbi.nlm.nih.gov/pubmed/24899053 |
| Ease of surgical wound closure | 21 days | Estimated ease of surgical wound closure. The patients'wound was discussed by at least two surgeons to obtain agreement on a 14- point Ease of Closure scale. This was done on day 0 as well as day 21. The scale ranged from a score of 0, meaning the wound was closed or so small as to require no closure technique, to a score of 13, meaning that it was not possible to close the wound with known reconstructive surgical techniques. A higher value therefore correlates with more complex surgery. More information: https://www.ncbi.nlm.nih.gov/pubmed/10231510 |
Countries
Germany
Outcome results
None listed