Biological approach for the management of non-healing diabetic foot ulcers
Autor: | Andima Basterretxea, Eva Rubio-Azpeitia, Elena Perez-Zabala, Ainara Larrazabal, Isabel Andia, Karmele Perez-del-Pecho |
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Rok vydání: | 2016 |
Předmět: |
Male
0301 basic medicine medicine.medical_specialty animal diseases Inflammation Dermatology Pathology and Forensic Medicine law.invention 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Fibrosis law medicine Humans Dry needling Platelet-Rich Plasma business.industry Middle Aged medicine.disease Diabetic foot Diabetic Foot nervous system diseases Surgery Treatment Outcome 030104 developmental biology Diabetic foot ulcer Fibrin scaffold Platelet-rich plasma medicine.symptom business |
Zdroj: | Journal of Tissue Viability. 25:157-163 |
ISSN: | 0965-206X |
Popis: | Objective To show an approach to profit of the main components of platelet rich plasma (PRP), i.e. the signaling proteins, and the fibrin scaffold and discuss the intervention within TIME (Tissue, Inflammation/Infection, Moisture, Edges) framework. Methods Two patients with diabetic foot ulcers are treated with both liquid and gelled PRP, and the rationale for the PRP intervention is described herein. Autologous blood is withdrawn and, PRP is separated by single spinning and activated with CaCl 2 prior to application. PRP is injected in an activated liquid form, i.e. freshly activated, before coagulation, within the wound edges. In fibrotic tissue PRP is introduced performing a needling procedure. In addition, PRP, clotted ex-vivo , is applied in the wound bed as a primary dressing. Results Both patients responded positively to PRP intervention. Case 1 healed after five weekly PRP applications. Case 2 healed after eight weekly PRP applications. Patient satisfaction was high in both cases. The procedure had no complications, is well tolerated and easy to perform in any medical setting. Conclusion PRP intervention is safe and if associated with correct tissue debridement and preparation of the host tissue it may help to decrease the burden of diabetic foot ulcers. Carefully designed randomized clinical trials with special attention to the PRP procedure are needed to assess the efficacy of these interventions. |
Databáze: | OpenAIRE |
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