Department of Dermatology and Venereology, Medical University Sofia, Bulgaria.
Department of Dermatology and Venereology, Military Medical Academy Sofia, Bulgaria.
J Biol Regul Homeost Agents. 2018 May-Jun;32(3):593-597.
Venous leg ulcers (VLUs) are chronic difficult-to-treat wounds which affect around 1-2% of the world population. Conventional methods for treatment such as mechanical debridement, occlusive dressings and local antibiotics in case of infection, often lack effectiveness. Autologous platelet-rich plasma (PRP) is an alternative method in the treatment of chronic wounds. PRP contains inflammatory mediators, growth factors, and cytokines that modulate the wound microenvironment to create a better chance for healing. The aim of this prospective clinical study was to evaluate the efficacy of intralesional injection of PRP in the management of VLUs. This study included 23 patients with VLUs. For each patient, two ulcers located in the same anatomical zone and at the same clinical stage were selected. One was treated with a single application of autologous PRP. The other ulcer was used as a control and was treated by conventional methods. The size of the ulcers was assessed at baseline (visit 0), 15 days (visit 1) and 30 days after the procedure (visit 2). Results showed a significant reduction of the size of the ulcer both in the group treated with PRP (mean surface 1368.2 mm2 at visit 0 and 596.3 mm2 at visit 2) and in the control group (mean surface 880.3 mm2 at visit 0 and 582.8 mm2 at visit 2). Statistical analysis showed a significant change in the size of the ulcer between visit 0 and visit 2 in both groups (p less than 0.0001). The application of PRP in difficult-to-treat venous leg ulcers may be a promising new method for therapy of this condition. The results of this study correlate with the data from the majority of previous studies and confirm the effectiveness of PRP. Nevertheless further research in the area is needed to evaluate the therapeutic significance of the method and eventually show its superiority to conventional treatments in larger cohorts.
静脉性腿部溃疡（VLUs）是一种慢性、难以治疗的伤口，影响着全球约 1-2%的人口。传统的治疗方法，如机械清创、封闭敷料和感染时使用局部抗生素，往往效果不佳。自体富含血小板的血浆（PRP）是治疗慢性伤口的一种替代方法。PRP 含有炎症介质、生长因子和细胞因子，可调节伤口微环境，为愈合创造更好的机会。本前瞻性临床研究旨在评估 PRP 腔内注射治疗 VLUs 的疗效。该研究纳入了 23 例 VLUs 患者。对于每位患者，选择位于同一解剖区域且处于相同临床阶段的两个溃疡。一个用单次自体 PRP 治疗。另一个溃疡作为对照，采用常规方法治疗。在基线（就诊 0）、治疗后 15 天（就诊 1）和 30 天（就诊 2）评估溃疡大小。结果显示，PRP 治疗组（就诊 0 时平均面积为 1368.2mm2，就诊 2 时为 596.3mm2）和对照组（就诊 0 时平均面积为 880.3mm2，就诊 2 时为 582.8mm2）的溃疡面积均显著减小。统计分析显示，两组在就诊 0 和就诊 2 之间，溃疡面积均有显著变化（p 均小于 0.0001）。PRP 应用于治疗困难的静脉性腿部溃疡可能是治疗该疾病的一种有前途的新方法。本研究结果与大多数先前研究的数据相吻合，证实了 PRP 的有效性。然而，需要在该领域进行进一步研究，以评估该方法的治疗意义，并最终在更大的队列中显示其优于常规治疗的优势。
