Optimizing the treatment procedure in crural ulcers – a pilot study of the surgical method
Authors:
I. Slaninka 1,2; L. Klein 1,2; R. Čáp 2,3; F. Hošek 2; I. Guňka 1,2; O. Šedivý 1,2; S. Jiška 1,2; M. Kaška 1,2
Authors place of work:
Katedra chirurgie, LF UK v Hradci Králové, vedoucí katedry: doc. MUDr. RNDr. M. Kaška, Ph. D.
1; Chirurgická klinika LF UK a FN Hradec Králové, přednosta kliniky: prof. MUDr. A. Ferko, CSc.
2; Katedra válečné chirurgie, Fakulta vojenského zdravotnictví UO, Hradec Králové
vedoucí katedry: doc. MUDr. J. Páral, Ph. D.
3
Published in the journal:
Rozhl. Chir., 2015, roč. 94, č. 2, s. 69-73.
Category:
Original articles
Summary
Introduction:
Current medical knowledge has provided us with a wide range of possibilities of treating chronic wounds. Over the recent decades, in particular, significant progress has been made in this field. The authors present an overview of current knowledge of chronic wound healing, pointing out the surgeon’s role in the process of chronic wound management. Using surgical therapy, we are able to heal a chronic wound in a shorter period of time, particularly if the treatment is accelerated by the application of platelet-rich plasma (PRP) as a source of growth factors.
Methods:
The pilot randomized prospective study included four patients with chronic wounds of the lower leg after previous failure of conservative therapy who were indicated for skin transplantation. Following previous vacuum-assisted closure therapy, the patients undergoing skin transplantation were prospectively randomized into two groups. Autologous PRP was used in one of the groups and standard skin transplantation without PRP was performed in the other one.
Results:
In the PRP group, 99% of the wound areas were healed on the 15th day after the operation. In the other group, 90% of the areas were healed on the 15th day following the operation. In the PRP group, complete healing of the defect occurred in both patients at 15 and 20 days post-surgery. In the second group, one patient completely healed within 28 days; the other one was not fully healed even at 3 months post-surgery.
Conclusions:
Most patient groups at great risk may benefit from the method using PRP, as well as patients with chronic wounds who have failed conventional methods available for both general and local therapy. This fact has been confirmed by the authors’ initial experience presented.
Key words:
platelet-rich plasma (PRP) – platelets − wound healing − chronic wound
Zdroje
1. Wysocki AB. Evaluating and managing open skin wounds: colonization versus infection. AACN Clin Issues 2002;13:382−97.
2. Graziani F, Ivanovski S, Cei S, et al. The in vitro effect of different PRP concentrations on osteoblasts and fibroblasts. Clin Oral Implants Res 2006;17:212−9.
3. Driver VR, Hanft J, Fylling CP, et al. Autologel Diabetic Foot Ulcer Study Group. A prospective, randomized, controlled trial of autologous platelet-rich plasma gel for the treatment of diabetic foot ulcers. Ostomy Wound Manage. 2006;52:68−70.
4. PietrzakWS, Eppley BL. Platelet rich plasma: biology and new technology. J Craniofac Surg 2005;16:1043−54.
5. Lindeboom JA, Mathura KR, Aartman IH, et al. Influence of the application of platelet-enriched plasma in oral mucosal wound healing. Clin Oral Implants Res 2007;18:133−9.
6. Wrotniak M, Bielecki T, Gazdzik TS. Current opinion about using the platelet-rich gel in orthopaedics and trauma surgery. Ortop Traumatol Rehabil 2007;9:227−38.
7. Frechette JP, Martineau I, Gagnon G. Platelet-rich plasmas: growth factor content and roles inwound healing. JDent Res 2005;84:434−9.
8. Bhanot S, Alex JC. Current applications of platelet gels in facial plastic surgery. Facial Plast Surg 2002;18:27−33.
9. Nachman RL, Rafii S. Platelets, petechiae, and preservation of the vascular wall. The New England Journal of Medicine 2008;359:1261−70.
10. Rendu F, Brohard-Bohn B. The platelet release reaction: granules’ constituents, secretion and functions. Platelets 2001;12:261−73.
11. Anitua E, Andia I, Ardanza B, et al. Autologous platelets as a source of proteins for healing and tissue regeneration. Tromb Haemost 2004;91:4−15.
12. Qureshi AH, Chaoji V, Maiguel D, et al. Proteomic and phospho-proteomic profile of human platelets in basal, resting state: insights into integrin signaling. PLoS One 2009;4:e7627.
13. Sánchez-González DJ, Méndez-Bolaina E, Trejo-Bahena NI. Platelet-rich plasma peptides: key for regeneration. Int J Pept 2012;2012:532519.
14. Borregaard N, Cowland JB. Granules of the human neutrophilic polymorphonuclear leukocyte. Blood 1997;89:3503−21.
15. Cole BJ, Seroyer ST, Filardo G, et al. Platelet-rich plasma: where are we now and where are we going? Sports Health 2010;2:203−10.
16. Stryja J. The use of platelet-rich fibrin in the complex treatment of crural ulcer – case report. Hojení ran 2012;6:17−21.
17. Dionyssiou D, Demiri E, Foroglou P, et al. The effectiveness of intralesional injection of platelet-rich plasma in accelerating the healing of chronic ulcers. An experimental and clinical study. Int Wound J 2012;10:1111:17.
18. Sakata J, Sasaki S, Handa K, et al. A retrospective, longitudinal study to evaluate healing lower extremity wounds in patients with diabetes mellitus and ischemia using standard protocols of care and platelet-rich plasma gel in a Japanese wound care program. Ostomy Wound Manage 2012;58:36−49.
19. Shengyun H, Zuolin W. Platelet-rich plasma-derived growth factors promotes osteogenic differentiation of rat muscle satellite cells: in vitro and in vivo studies. Cell Biol Int 2012;36:1195−1205.
20. Klosová H. Operační léčba hlubokých popálenin kombinací dermoepidermální autotransplantace a lokální transplantace koncentrátu autologních trombocytů. Hradec Králové, 2014. Doktorská disertační práce, Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové.
21. Abate M, Di Gregorio P, Schiavone C, et al. Platelet rich plasma in tendinopathies: how to explain the failure. Int J Immunopathol Pharmacol 2012;25:325−34.
22. Casati MZ, de Vasconcelos Gurgel BC, Gonçalves PF, el al. Platelet-rich plasma does not improve bone regeneration around peri-implant bone defects-a pilot study in dogs. Int J Oral Maxillofac Surg 2007;36:132−6.
Štítky
Surgery Orthopaedics Trauma surgeryČlánok vyšiel v časopise
Perspectives in Surgery
2015 Číslo 2
- Spasmolytic Effect of Metamizole
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole in perioperative treatment in children under 14 years – results of a questionnaire survey from practice
Najčítanejšie v tomto čísle
-
Laparotomy closure – do we know how?
(Guideline of the European Hernia Society) - Overview of primary sternal closure techniques
- Synovial sarcoma of the liver – case report
- Rare discovery of metastasis of renal cell carcinoma in location of struma polynodosa