Treatment of chronic non-healing ulcers using autologous platelet rich plasma: a case series.
Treatment of chronic non-healing ulcers using autologous platelet rich plasma: a case series.
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使用自体富血小板血浆治疗慢性不愈合溃疡：病例系列。
DOI：
10.1186/s12929-017-0324-1
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发表时间：
2017-02-27
影响因子：
11
通讯作者：
Ponemone V
中科院分区：
文献类型：
--
作者：
Suthar M;Gupta S;Bukhari S;Ponemone V
不愈合性溃疡是世界范围内的一个主要健康问题，对个人、职业和社会层面都有很大影响，在人力和物力资源方面成本很高。顽固性非愈合性溃疡是不可避免的，对下肢有害，是非创伤性下肢截肢的主要原因。自体富血小板血浆（PRP）的应用已经成为治疗不愈合和糖尿病足溃疡的重大突破，因为它是一种简单且具有成本效益的方法，并提供了促进组织愈合的必要生长因子。PRP是由血小板α颗粒分泌的血小板、细胞因子和各种生长因子的聚集体，其随着时间的减少而增加自然愈合过程的速率。本病例系列旨在评价自体富血小板血浆治疗下肢慢性不愈合溃疡的安全性和有效性。使用基于密度梯度离心原理的快速术中床旁系统从全血制备AutoblastPRP。符合入选标准的24例不同病因的非愈合性溃疡患者接受单次皮下PRP注射沿着PRP凝胶局部应用治疗。治疗患者的平均年龄为62.5 ± 13.53岁，随访时间为24周。所有患者均显示伤口愈合迹象，伤口尺寸缩小，溃疡愈合平均持续时间为8.2周。此外，在使用快速床旁装置获得的最终PRP产品中观察到血小板浓缩物平均增加5倍，给予患者的平均血小板剂量为70.10 × 108。该病例系列证明了自体富血小板血浆治疗慢性不愈合溃疡的潜在安全性和有效性。 NCT 03026855，于2017年1月4日注册“Retrophobic”
Non-healing ulcers are a major health problem worldwide and have great impact at personal, professional and social levels, with high cost in terms of human and material resources. Recalcitrant non-healing ulcers are inevitable and detrimental to the lower limb and are a major cause of non-traumatic lower limb amputations. Application of autologous Platelet Rich Plasma (PRP) has been a major breakthrough for the treatment of non-healing and diabetic foot ulcers, as it is an easy and cost-effective method, and provides the necessary growth factors that enhance tissue healing. PRP is a conglomeration of thrombocytes, cytokines and various growth factors which are secreted by α-granules of platelets that augment the rate of natural healing process with decrease in time. The purpose of this case series was to evaluate the safety and efficacy of autologous platelet rich plasma for the treatment of chronic non-healing ulcers on the lower extremity. Autologous PRP was prepared from whole blood utilizing a rapid, intraoperative point-of-care system that works on the principle of density gradient centrifugation. Twenty Four (24) patients with non-healing ulcers of different etiologies, who met the inclusion criteria, were treated with single dose of subcutaneous PRP injections along with topical application of PRP gel under compassionate use. The mean age of the treated patients was 62.5 ± 13.53 years and they were followed-up for a period of 24 weeks. All the patients showed signs of wound healing with reduction in wound size, and the mean time duration to ulcer healing was 8.2 weeks. Also, an average five fold increase in the platelet concentrate was observed in the final PRP product obtained using the rapid point-of-care device, and the average platelet dose administered to the patients was 70.10 × 108. This case series has demonstrated the potential safety and efficacy of autologous platelet rich plasma for the treatment of chronic non-healing ulcers. NCT03026855, Registered 4 January 2017 ‘Retrospectively’