Use of Platelet-rich Plasma in the Treatment of Recalcitrant Sinus Tracts: A Case Series

Sinus tract formation is common in a wide variety of wounds and can be difficult to manage. Nonsurgical techniques for treating sinus tracts have generally been disappointing, though many nonsur- gical options have been explored including dermal matrix injection, platelet-derived growth factors, fibrin sealant, and phenytoin. This case series explores the treatment of nonhealing chronic wound-related si- nus tracts with autologous platelet-rich plasma (PRP) in a series of patients in a single center, hospital-based, chronic wound care cen- ter.

PRP was prepared using the Harvest SmartPRep pro- cedure. During processing, the blood was separated into two distinct chambers: one containing packed red blood cells, and the other with autologous platelet concentrate and plasma supernatant. The plasma was injected into the entire sinus tract beginning from the base of the tract.

Nine of 12 patients healed, and three did not heal and required other interventions (excision and flap repair). All patients, ex- cept one, received only one PRP injection. One case of infection that could be directly attributed to the PRP injection was reported. All other patients experienced no pain, discomfort, or signs or symptoms of in- fection.

PRP injection can be a useful technique in cases of straight, relatively short, persistent sinus tracts.