PRP treatment of diabetic foot ulcers and wounds

With PRP treatment against diabetes

Diabetic foot ulcers are the most common cause of leg amputations worldwide and there are several studies demonstrating the central role of altered granulation tissue formation in these chronic ulcers. It therefore seems reasonable that platelet-rich plasma (PRP) with multiple cytokines/growth factors may alter these sessile ulcers more rapidly during healing by closing the wound sooner and reducing the need for permanent amputations. 

What foot problems are associated with diabetes?

If you have diabetes, it is important to check your feet regularly. You should see a podiatrist if any of the following problems occur:

  • Blisters, wounds and cuts
  • Corns and calluses.
  • Nail fungus
  • bunions and hammertoes. 
  • Plantar warts
  • Athlete's foot
  • Ingrown toenails

All these problems can get worse if they are not treated. If you cannot easily check your own feet, a doctor should help you. 

How are diabetic foot ulcers treated?

Conventional treatments for diabetic foot ulcers include rest, bandaging, and topical and oral medications. A doctor can also determine if you are a candidate for platelet-rich plasma (PRP) injections, which have a high success rate in healing diabetic ulcers.

For these injections, he takes a blood sample, filters it and turns it to concentrate the platelets. The platelets contain essential growth factors for healing. The doctor then injects the PRP into areas of your body that need help to heal.

Does PRP help in the treatment of diabetic foot ulcers?

Diabetics have been found to have reduced tissue growth factor concentrations, especially epidermal growth factor. This deficiency impairs wound healing, leading to their chronic development and the risk of amputation. Diabetic ischaemic foot ulcers are the most difficult to treat and are associated with the highest risk of amputation. 

Diabetics in combination with foot disorders often have a difficult clinical management. Such patients are prone to bone disease or a period of osteoarticular fusion surgery, mild to concomitant infections and difficult-to-heal skin ulcers.

Basic research has shown that the concentration of several important growth factors is significantly reduced at the site of diabetic foot injury. In recent years, it has been shown that in patients with diabetes who did not undergo Charcot art reconstruction, PDGF and VEGF levels at the bone fusion site were significantly lower than in normal individuals.

PRP contains several growth factors that are clinically related to the use of PRP therapy in Charcot joint reconstruction. 

In a multicentre, prospective, clinical randomised controlled trial, Driver VR used autologous PRP gel to treat diabetic foot ulcers. A total of 40 eligible patients participated in the study. They were randomly divided into two groups: One treatment group received topical treatment with PRP gel. The control group received a saline gel treatment.  Ulcer healing was assessed every 12 weeks for a total of 12 weeks.  Thirteen (68.4%) and 9 (42.9%) ulcers recovered in the treatment and control groups, respectively. Kaplan-Meier time-to-cure analysis also showed that the PRP treatment group was significantly better than the control group. No serious side effects occurred during PRP treatment. The study concluded that the use of PRP was very effective for diabetic foot ulcers.

How does PRP therapy work?

PRP therapy can repair injuries and relieve pain in the body. It is associated with faster healing, a significant reduction in pain and a much lower risk than other treatments. 

Growth factors and proteins are found in the platelets of the blood. These elements are designed to stimulate healing, support cell growth and generate new tissue. The body's first response to a soft tissue injury is to bring a rush of platelets to the site to speed up the repair process.

PRP therapy is a form of regenerative medicine that uses the natural healing powers of blood. The procedure involves extracting and isolating platelets and plasma from a sample of your own blood, then the doctor concentrates it in a healing solution. It is then injected back into the body at (and around) the point of injury or pain. 

When the growth factors interact with local cells, they trigger the cells to heal the injury. This promotes tissue formation and reduces inflammation. The PRP solution can also provide a lubricating factor.

Summary

Diabetic foot ulceration is a major health problem and leads to amputation in 15%. There is a prolonged inflammatory phase that leads to a delay in granulation tissue formation and a decrease in the tensile strength of the wound. PRP improves wound healing by providing the necessary growth factors and reducing inflammation. Autologous PRP is a safe and cost-effective method of treating diabetic foot ulcers.

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