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Platelet-Rich Plasma in the Treatment of Diabetic Foot Ulcers
Paul T Gomez1, Karen L Andrews, Jennifer R Arthurs
1At Mayo Clinic, Rochester, Minnesota, United States, Paul T. Gomez, BS, is Summer Research Fellow, Regenerative Sciences Track, Mayo Clinic Graduate School of Biomedical Sciences; Saranya P. Wyles, MD, PhD, is Consultant, Department of Dermatology; and Karen L. Andrews, MD, is Director, Vascular Ulcer and Wound Healing Clinic/Gonda Vascular Center, and Consultant, Department of Physical Medicine and Rehabilitation. At Mayo Clinic, Jacksonville, Florida, Jennifer R. Arthurs is APRN, Center for Regenerative Medicine; and Alison J. Bruce, MB, ChB, is Consultant, Department of Dermatology.
Background:
Chronic nonhealing neuropathic foot ulcers affect approximately 15% to 30% of patients with diabetes mellitus and are associated with significant morbidity and mortality. Although current strategies to address these chronic wounds include a multifactorial approach, clinical outcomes remain poor and warrant improvement. Platelet-rich plasma (PRP), derived from autologous or allogeneic blood, is an emerging regenerative product that aims to serve as an adjuvant to standard diabetic foot ulcer (DFU) treatment.
Objective:
To examine controlled clinical trials investigating the efficacy of platelet-rich therapies in promoting healing of chronic DFUs.
Data Sources:
The PubMed/MEDLINE database.
Study Selection:
Researchers selected 11 controlled clinical trials published between 2011 and 2021 that investigated the efficacy of PRP treatments for chronic DFUs.
Data Extraction:
Extracted data included study type and size, participant sex and age, duration of diabetes, glycated hemoglobin levels, baseline ulcer area, wound duration, healing parameters, PRP preparation approach, and application type.
Data Synthesis:
Randomized prospective studies (n = 8), prospective controlled studies (n = 2), and a double-blind, randomized controlled study (n = 1) were included in the review. In general, PRP plus standard of care provided superior wound healing, in both percentage of wound closure and healing rate, compared with standard of care alone.
Conclusions:
Use of PRP as an adjuvant for healing chronic DFUs appears to improve wound healing. Further research on optimizing PRP preparation and exploring combinatorial approaches will be important in advancing this avenue for chronic wound healing.
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