Dr Devesh Dubey, Senior Resident, Department of Transfusion Medicine and Blood Bank, All India Institute Of Medical Sciences (AIIMS), Bhopal, India; E-mail:
Mymensingh Med J. 2024 Jul;33(3):888-896.
Chronic non-healing ulcers present significant challenges in diabetic, dermatological and surgical patients. Platelet-Rich Plasma (PRP), enriched with bioactive factors, offers promise for wound healing enhancement. The prospective observational study was done in the Department of Transfusion Medicine at AIIMS Bhopal for a period of two years, from April 2020 to 2022. This study evaluates PRP's efficacy, prepared via the single spin method, in non healing chronic ulcers. Aseptically, 100 ml of blood was drawn into CPDA (citrate-phosphate-dextrose-adenine) bags. PRP was prepared by centrifuging blood at 3400 rpm for 10 minutes, yielding PRP and buffy coat. Patient serum and 10.0% calcium gluconate were added to fibrin gel. PRP was injected around the ulcer and then dressed. Dressings were changed on the 5th, 15th and 20th days with PRP. The evaluation was done on day 30 using surface area and volume assessments. Thirteen patients aged 18-65 participated. The patients treated with single spin PRP (four females, nine males) had mean hemoglobin of 10.79±2.22gm/dL. Initial lesions (14.72cm²) significantly reduced to (8.78cm²) after application of single Spin PRP sessions (p=0.005). The PRP showed a mean platelet count of 1,527.00±192.26 × 10⁹/L. Ulcer surface area decreased from 9.87cm² to 7.56cm²; lesion volume reduced from 14.72cm³ to 8.78cm³. Platelet count differences between whole blood and PRP were significant (p<0.05). The single-spin PRP method exhibited considerable improvements in healing parameters, showcasing its potential for chronic ulcer management.
慢性非愈合性溃疡在糖尿病、皮肤科和外科患者中带来了重大挑战。富含生物活性因子的富血小板血浆(PRP)为伤口愈合增强带来了希望。这项前瞻性观察研究在 2020 年 4 月至 2022 年期间在 AIIMS 博帕尔的输血医学系进行,为期两年。本研究评估了通过单旋法制备的 PRP 在非愈合性慢性溃疡中的疗效。通过无菌操作,从 CPDA(柠檬酸盐-磷酸盐-葡萄糖-腺嘌呤)袋中抽取 100ml 血液。将血液以 3400rpm 的速度离心 10 分钟,得到 PRP 和白细胞层。将患者血清和 10.0%葡萄糖酸钙加入纤维蛋白凝胶中。将 PRP 注射到溃疡周围,然后进行包扎。用 PRP 在第 5、15 和 20 天更换敷料。在第 30 天使用表面积和体积评估进行评估。共有 13 名 18-65 岁的患者参与了研究。接受单旋 PRP 治疗的患者(4 名女性,9 名男性)平均血红蛋白为 10.79±2.22g/dL。初始病变(14.72cm²)在应用单旋 PRP 治疗后显著缩小至(8.78cm²)(p=0.005)。PRP 的平均血小板计数为 1527.00±192.26×10⁹/L。溃疡表面积从 9.87cm²减少到 7.56cm²;病变体积从 14.72cm³减少到 8.78cm³。全血和 PRP 之间的血小板计数差异有统计学意义(p<0.05)。单旋 PRP 法在愈合参数方面表现出相当大的改善,展示了其在慢性溃疡管理中的潜力。