PLATELET-RICH PLASMA FOR PERSISTENT ULCERS OF THE LOWER LIMBS
I. V. Gilevich,
T. V. Fedorenko,
E. A. Kolomiytseva,
V. V. Fedyushkin,
E. N. Shubrov,
S. G. Slavinsky 
Abstract
Background. Estimation of safety and efficiency of platelet-rich plasma in complex treatment in patients with persistent large ulcers.
Material and methods. Two clinical cases of patients with long persistent ulcers of the lower extremities that were administered local injections of the autologic platelet-rich plasma in the wound area in combination with or without autodermoplasty.
Results. In the first case the patient had a trophic ulcer after erysipelatous inflammation without dynamics to healing in the setting of the carried treatment. Surgery was contraindicated due to severe accompanying pathology. This patient had 6 PRP courses (once a week). The regional epithelialization appeared on the 2nd week. After 6 injections full wound healing was noted. In the second case the patient had a long persistent post-traumatic ulcer with 2% square. The autodermoplasty with local introduction of PRP was performed. We observed a full graft acceptance on the 6th day.
Conclusion. PRP use will allow to improve outcomes of treatment persistent ulcers of the lower extremities. It represents extremely important to continue work on PRP application due to an absence of complications and obvious contraindications in this method for carrying out comprehensive analysis.
About the Authors
I. V. Gilevich
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
Cand. of Sci. (Med.), head of the laboratory for development and study of new treatment technologies
350086, Krasnodar, 167, 1st May str.
T. V. Fedorenko
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
Biologist of the laboratory for development and study of new treatment technologies
E. A. Kolomiytseva
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
Biologist of the laboratory for development and study of new treatment technologies
V. V. Fedyushkin
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
Surgeon of the department of purulent surgery
E. N. Shubrov
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
Surgeon of the department of purulent surgery
S. G. Slavinsky
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
Cand. of Sci. (Med.), surgeon of the department of purulent surgery
References
1. Suryanarayan S., Budamakuntla L., Khadri S.I.S. et al. Efficacy of autologous platelet-rich plasma in the treatment of chronic nonhealing leg ulcers. Plastic Aesthetic Res. 2014;1(2):65-69. DOI:10.4103/2347-9264.139703.
2. Carducci M., Bozzetti M., Spezia M. et al. Treatment of a refractory skin ulcer using punch graft and autologous platelet-rich plasma. Case reports in dermatological medicine. 2016; р.4 http://dx.doi.org/10.1155/2016/7685939
3. Просянникова Н.В. Аутологичная, богатая тромбоцитами плазма в лечении язвенных пораже-ний кожи нижних конечностей: автореф. дисс. … канд. мед. наук. Москва, 2014. 124 c. [Prosyannikova N.V. Autologous, platelet-rich plasma in the treatment of ulcerative lesions of the skin of lower extremities. Сand med. sci. abstracts diss. Moscow, 2014. 124 p. (in Russ.)].
4. Богдан В.Г., Толстов Д.А. Проспективное рандомизированное клиническое исследование эффективности применения аутологичных тромбоцитар-ных концентратов для стимуляции регенерации трофических язв венозной этиологии. Новости хирургии. 2014;22(3):344-350. [Bogdan V.G., Tolstov D.A. Prospective randomized clinical trials of efficiency of autologous platelet-derived concentrates to stimulate regeneration of trophic ulcers of venous etiology. Novosti Khirurgii.2014;22(3):344-350. (in Russ.)].
5. Maxson S., Lopez E.A., Yoo D. et al. Concise review: role of mesenchymal stem cells in wound repair. Stem Cells Trans. Med. 2012;1:142–149. https://doi.org/10.5966/sctm.2011-0018.
6. Chicharro-Alcántara D., Rubio-Zaragoza M., Damiá-Giménez E. et al. Platelet rich plasma: new insights for cutaneous wound healing management. Journal of functional biomaterials. 2018;9(1):10. doi:10.3390/jfb9010010.
7. Носков С.М., Широкова Л.Ю., Аршинов А.В. и др. Применение локального введения аутологичной, обогащенной тромбоцитами плазмы у больной с язвенным дефектом кожи. Научно-практическая ревматология. 2011;1:66-68. [Noskov S.M., Shirokova L.Yu., Arshinov A.V. et al. Local administration of autologous platelet-rich plasma in a female patient with skin ulcer. Nauchno-prakticheskaya revmatologiya. 2011;1:66-68. (in Russ.)].
8. Оболенский В.Н. Хроническая рана: обзор со-временных методов лечения. РМЖ. 2013;21(5):282-89. [Obolenskij V.N. Chronic wound: a review of modern methods of treatment. RMZH. 2013;21(5):282-89. (in Russ.)].
9. Mulder G.D., Lee D.K., Faghihnia N. Autologous bone marrow-derived stem cells for chronic wounds of the lower extremity: a retrospective study. Wounds. 2010;22(9):219-225.
10. Metcalfe A.D., Ferguson M.W.J. Bioengineering skin using mechanisms of regeneration and repair. Biomaterials. 2007;28(34):5100-5113. https://doi.org/10.1016/j.biomaterials.2007.07.031.
11. Mansbridge J. Skin tissue engineering. Journal of Biomaterials Science, Polymer Edition. 2008;19(8):955-968. https://doi.org/10.1163/156856208784909417.
12. Shah J.M.Y., Omar E., Pai D. R. et al. Cellular events and biomarkers of wound healing. Indian journal of plastic surgery: official publication of the Association of Plastic Surgeons of India. 2012;45(2):220. doi:10.4103/0970-0358.101282.
13. Prakash S. Platelet concentrates: past, present and future. S. Prakash, A. Thakur. Maxillofac Oral Surg. 2011;10(1):45-49. https://doi.org/10.1007/s12663-011-0182-4.
14. Arwert E.N., Hoste E., Watt F.M. Epithelial stem cells, wound healing and cancer. Nature Reviews Cancer. 2012;12(3):170. DOI https://doi.org/10.1038/nrc3217.
15. Murphy M.B., Blashki D., Buchanan R.M. et al. Adult and umbilical cord blood-derived plateletrich plasma for mesenchymal stem cell proliferation, chemotaxis, and cryo-preservation. Biomaterials. 2012;33(21):5308-5316. https://doi.org/10.1016/j.biomaterials.2012.04.007.
16. Ahmad Z., Howard D., Brooks R.A. et al. The role of platelet rich plasma in musculoskeletal science. JRSM short reports. 2012;3(6):1-9. https://doi.org/10.1258/shorts.2011.011148.
17. Кирилова И.А., Фомичев Н.Г., Подорожная В.Т. и др. Сочетанное использование остеопластики и обогащенной тромбоцитами плазмы в травматологии и ортопедии. Травматология и ортопедия России. 2008;49(3):63-67. [Kirilova I.A., Fomichev N.G., Podorozhnaja V.T. i dr. Sochetannoe ispol’zovanie osteoplastiki i obogashhennoj trombocitami plazmy v travmatologii i ortopedii. Travmatologija i ortopedija Rossii. 2008;49(3):63-67. (In Russ.)].
18. Космачева С.М., Данилкович Н.Н., Щепень А.В. и др. Влияние релизата (releasate) тромбоцитов на остеогенную дифференцировку мезенхимальных стволовых клеток костного мозга человека. Клеточ-ные технологии в биологии и медицине. 2013;4:210-216. [Kosmacheva S.M., Danilkovich N.N., Shchepen’ A.V. et al. Effect of platelet releasate on osteogenic differentiation of human bone marrow mesenchymal stem cells. Kletochnye tekhnologii v biologii i medicine. 2013;4:210-216. (in Russ.)].
19. Villela D.L., Santos V.L.C.G. Evidence on the use of platelet-rich plasma for diabetic ulcer: a systematic review. Growth factors. 2010;28(2):111-116. https://doi.org/10.3109/08977190903468185.
20. Ozcelik U., Ekici Y., Bircan H.Y. et al. Effect of topical platelet-rich plasma on burn healing after partial-thickness burn injury. Medical science monitor: international medical journal of experimental and clinical research. 2016; 22:1903–1909. doi:10.12659/MSM.895395.
21. Sommeling C.E., Heyneman A., Hoeksema H. et al. The use of platelet-rich plasma in plastic surgery: a systematic review. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2013;66(3):301-311. https://doi.org/10.1016/j.bjps.2012.11.009.
22. Andia I., Abate M. Platelet-rich plasma: underlying biology and clinical correlates. Regenerative medicine. 2013;8(5):645-658. https://doi.org/10.2217/rme.13.59.
23. Borena B.M., Martens A., Broeckx S.Y. et al. Regenerative skin wound healing in mammals: state-ofthe-art on growth factor and stem cell based treatments. Cellular Physiology and Biochemistry. 2015;36(1):1-23. https://doi.org/10.1159/000374049.
24. De Vos R.J., van Veldhoven P.L., Moen M.H. et al. Autologous growth factor injections in chronic tendinopathy: a systematic review. British medical bulletin. 2010;95(1):63-77. https://doi.org/10.1093/bmb/ldq006.
25. Salarinia R., Sadeghnia H.R., Alamdari D.H. et al. Platelet rich plasma: Effective treatment for repairing of spinal cord injury in rat. Acta orthopaedica et traumatologica turcica. 2017;51(3):254-257. https://doi.org/10.1016/j.aott.2017.02.009.
26. Ahmed M., Reffat S.A., Hassan A. et al. Plateletrich plasma for the treatment of clean diabetic foot ulcers. Annals of vascular surgery. 2017;38:206-211. https://doi.org/10.1016/j.avsg.2016.04.023.
27. Hussain N., Johal H., Bhandari M. An evidencebased evaluation on the use of platelet rich plasma in orthopedics–a review of the literature. SICOT-J. 2017;3:7. doi:10.1051/sicotj/2017036.
28. Ronci C., Ferraro A.S., Lanti A. et al. Platelet-rich plasma as treatment for persistent ocular epithelial defects. Transfusion and Apheresis Science. 2015;52(3):300-304. https://doi.org/10.1016/j.transci.2014.12.027.
29. Ghoddusi J., Maghsudlu A., Jafarzadeh H. et al. Histological evaluation of the effect of platelet-rich plasma on pulp regeneration in nonvital open apex teeth: An Animal Study. The journal of contemporary dental practice. 2017;18(11):1045-1050. DOI:10.5005/jp-journals-10024-2173.
30. Suthar M., Gupta S., Bukhari S. et al. Treatment of chronic non-healing ulcers using autologous platelet rich plasma: a case series. Journal of biomedical science. 2017;24(1):16. https://doi.org/10.1186/s12929-017-0324-1.
31. Frykberg R.G., Driver V.R., Carman D. et al. Chronic wounds treated with a physiologically relevant concentration of platelet-rich plasma gel: a prospective case series. Ostomy wound management. 2010;56(6):36-44.
32. Steenvoorde P., van Doorn L.P., Naves C. et al. Use of autologous platelet-rich fibrin on hard-to-heal wounds. Journal of wound care. 2008;17(2):60-63.
33. Babaei V., Afradi H., Gohardani H.Z. et al. Management of chronic diabetic foot ulcers using plateletrich plasma. Journal of wound care. 2017;26(12):784-787. https://doi.org/10.12968/jowc.2017.26.12.784.
34. Roubelakis M.G., Trohatou O., Roubelakis A. et al. Platelet-rich plasma (PRP) promotes fetal mesenchymal stem/stromal cell migration and wound healing process. Stem Cell Reviews and Reports. 2014;10(3):417-428.
35. Amable P.R., Carias R.B., Teixeira M.V. et al. Platelet-rich plasma preparation for regenerative medicine: optimization and quantification of cytokines and growth factors. Stem cell research & therapy. 2013;4(3):13. https://doi.org/10.1186/scrt218.
36. Fernandez-Moure J.S., Van Eps J.L., Cabrera F.J. et al. Platelet-rich plasma: a biomimetic approach to enhancement of surgical wound healing. Journal of surgical research. 2017;207:33-44. https://doi.org/10.1016/j.jss.2016.08.063.
Review
For citations:
Gilevich I.V., Fedorenko T.V., Kolomiytseva E.A., Fedyushkin V.V., Shubrov E.N., Slavinsky S.G. PLATELET-RICH PLASMA FOR PERSISTENT ULCERS OF THE LOWER LIMBS. Innovative Medicine of Kuban. 2018;(4):17-24. (In Russ.)
Views:
725
Email this article 
