Salazar-Álvarez A E, Riera-del-Moral L F, García-Arranz M, Alvarez-García J, Concepción-Rodriguez N A, Riera-de-Cubas L
Servicio de Angiología y Cirugía Vascular, Hospital Universitario La Paz, Madrid, España.
Servicio de Angiología y Cirugía Vascular, Hospital Universitario La Paz, Madrid, España.
Actas Dermosifiliogr. 2014 Jul-Aug;105(6):597-604. doi: 10.1016/j.ad.2013.12.011. Epub 2014 Mar 12.
Platelet-rich plasma (PRP) is used as an adjuvant in the treatment of chronic ulcers of the lower extremity and has shown particularly promising results in the case of neuropathic ulcers. There has been less research, however, into its use in venous and hypertensive ulcers. Our aim was to assess the safety and feasibility of using PRP in the treatment of chronic ulcers of the lower extremity and to evaluate its potential benefits in directed healing.
We prospectively selected 11 patients with nonischemic ulcers of the lower extremity that had been present for at least 6 weeks. PRP was injected subcutaneously into the perilesional tissue and applied topically in 4 sessions held at 1-week intervals. We assessed quality of life (SF-12 questionnaire), pain (visual analog scale), and the circumference of the ulcer before and after treatment.
There was a predominance of women (8/11, 73%), and venous ulcers (7/11, 64%) were more common than hypertensive ulcers (4/11, 36%). The median age of the patients was 79 years and the median time since onset of the ulcer was 17 months (range, 6-108 months). We observed a significant reduction in pain (P<.05) and a significant improvement in the physical and mental components of the SF-12 (P<.05). The mean reduction in ulcer size was 60%, and complete healing was achieved in 5 cases. No adverse effects were observed.
The local application of PRP is a valuable and practical procedure that promotes the healing of chronic ulcers of the lower extremity; it can improve patient quality of life and is particularly effective in local pain relief.
富血小板血浆(PRP)被用作治疗下肢慢性溃疡的辅助手段,在神经性溃疡的治疗中已显示出特别有前景的结果。然而,对于其在静脉性和高血压性溃疡中的应用研究较少。我们的目的是评估使用PRP治疗下肢慢性溃疡的安全性和可行性,并评估其在定向愈合方面的潜在益处。
我们前瞻性地选择了11例下肢非缺血性溃疡患者,这些溃疡已存在至少6周。将PRP皮下注射到溃疡周围组织,并分4次局部应用,每次间隔1周。我们在治疗前后评估了生活质量(SF-12问卷)、疼痛(视觉模拟量表)和溃疡周长。
女性占多数(8/11,73%),静脉性溃疡(7/11,64%)比高血压性溃疡(4/11,36%)更常见。患者的中位年龄为79岁,溃疡发病后的中位时间为17个月(范围6 - 108个月)。我们观察到疼痛显著减轻(P <.05),SF-12的身体和心理成分有显著改善(P <.05)。溃疡大小的平均缩小率为60%,5例实现了完全愈合。未观察到不良反应。
PRP的局部应用是一种有价值且实用的方法,可促进下肢慢性溃疡的愈合;它可以改善患者的生活质量,在局部疼痛缓解方面特别有效。