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Platelet-rich plasma may facilitate ulcer healing

Platelet-rich plasma, or PRP, appears to yield healing in ulcers as it changes the matrix metalloproteinase and cytokine expression shortly after topical application, according to researchers.

“These articles demonstrate that topical activated PRP or autologous leukocyte- and platelet-rich fibrin applied once to twice a week for 3 to 6 weeks improves wound healing and support a standardized treatment regimen for PRP in chronic ulcers,” Michael J. Hesseler, MD, of the department of dermatology at University of Michigan, and colleagues wrote.

In the review from Journal of the American Academy of Dermatology, researchers focused on dermatological conditions excluding alopecia, acne scarring and skin rejuvenation to uncover the available evidence of PRP.

In a case series of 200 patients with 285 refractory chronic wounds of a variety of etiologies, activated autologous pure PRP (P-PRP) gel was applied topically once or twice weekly. After 2.2 weeks, 86.3% of the wounds responded with an area reduction of 47.5%, and 90.5% of the wounds exhibited a 63.6% reduction, according to researchers.

In another cohort, weekly topical autologous leukocyte- and platelet-rich fibrin (L-PRF) resulted in complete resolution in every patient with small venous ulcers, diabetic foot ulcers or complex multifactorial wounds.

Moreover, in acute traumatic wounds from a control trial of 59 patients, topical application of activated autologous undefined PRP (uPRP) gel weekly for 3 weeks exhibited improvements in wound surface area and pain scores.

In trials of patients with chronic diabetic ulcers, patients showed faster healing rates, greater improvements in healing grades and time to healing, according to researchers.

The researchers also report success in healing pressure ulcers. Two doses of uPRP and hyaluronic acid produced greater healing than one dose of uPRP alone.

In a study of 40 patients with chronic venous leg ulcers, topical activated autologous leukocyte-rich PRP (L-PRP) gel significantly improved the mean ulcer area at 6 weeks.

“PRP might contribute to peripheral nerve regeneration and healing of ulcers secondary to neuropathy,” the researchers wrote.

Moreover, when combined with narrowband ultraviolet B or CO₂ laser therapy, PRP can produce better results in stable vitiligo, they continued.

“PRP presents an attractive option for treatment-resistant chronic ulcers, which remains a significant economic burden in health care today,” the researchers wrote. – by Abigail Sutton

Disclosures: The authors report no relevant financial disclosures.