Perez-Zabala Elena, Basterretxea Andima, Larrazabal Ainara, Perez-Del-Pecho Karmele, Rubio-Azpeitia Eva, Andia Isabel
Hospital-at-Home Department, Cruces University Hospital, OSI, Pza Cruces S/N, 48903 Barakaldo, Spain.
BioCruces Health Research Institute, Cruces University Hospital, Pza Cruces S/N, 48903 Barakaldo, Spain.
J Tissue Viability. 2016 May;25(2):157-63. doi: 10.1016/j.jtv.2016.03.003. Epub 2016 Mar 23.
To show an approach to profit of the main components of platelet rich plasma (PRP), i.e. the signaling proteins, and the fibrin scaffold and discuss the intervention within TIME (Tissue, Inflammation/Infection, Moisture, Edges) framework.
Two patients with diabetic foot ulcers are treated with both liquid and gelled PRP, and the rationale for the PRP intervention is described herein. Autologous blood is withdrawn and, PRP is separated by single spinning and activated with CaCl2 prior to application. PRP is injected in an activated liquid form, i.e. freshly activated, before coagulation, within the wound edges. In fibrotic tissue PRP is introduced performing a needling procedure. In addition, PRP, clotted ex-vivo, is applied in the wound bed as a primary dressing.
Both patients responded positively to PRP intervention. Case 1 healed after five weekly PRP applications. Case 2 healed after eight weekly PRP applications. Patient satisfaction was high in both cases. The procedure had no complications, is well tolerated and easy to perform in any medical setting.
PRP intervention is safe and if associated with correct tissue debridement and preparation of the host tissue it may help to decrease the burden of diabetic foot ulcers. Carefully designed randomized clinical trials with special attention to the PRP procedure are needed to assess the efficacy of these interventions.
展示一种从富含血小板血浆（PRP）的主要成分，即信号蛋白和纤维蛋白支架中获取益处的方法，并在TIME（组织、炎症/感染、湿度、边缘）框架内讨论干预措施。
对两名糖尿病足溃疡患者使用液体和凝胶状PRP进行治疗，并在此描述PRP干预的基本原理。抽取自体血，通过单次离心分离出PRP，并在应用前用氯化钙激活。PRP以激活的液体形式注射，即在伤口边缘内凝血前新鲜激活后注射。在纤维化组织中，通过针刺程序注入PRP。此外，体外凝结的PRP作为主要敷料应用于伤口床。
两名患者对PRP干预均有积极反应。病例1在每周应用PRP五次后愈合。病例2在每周应用PRP八次后愈合。两例患者的满意度都很高。该程序无并发症，耐受性良好，在任何医疗环境中都易于实施。
PRP干预是安全的，如果与正确的组织清创和宿主组织准备相结合，可能有助于减轻糖尿病足溃疡的负担。需要精心设计的随机临床试验，并特别关注PRP程序，以评估这些干预措施的疗效。
