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Autologous platelet‐rich gel for treatment of diabetic chronic refractory cutaneous ulcers: A prospective, randomized clinical trial
Author(s) -
Li Lan,
Chen Dawei,
Wang Chun,
Yuan Nanbing,
Wang Yan,
He Liping,
Yang Yanzhi,
Chen Lihong,
Liu Guanjian,
Li Xiujun,
Ran Xingwu
Publication year - 2015
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/wrr.12294
Subject(s) - medicine , diabetic foot , clinical endpoint , refractory (planetary science) , randomized controlled trial , surgery , subgroup analysis , diabetes mellitus , clinical trial , confidence interval , physics , astrobiology , endocrinology
The purpose of the study is to examine the safety and effectiveness of topical autologous platelet‐rich gel (APG) application on facilitating the healing of diabetic chronic refractory cutaneous ulcers. The study was designed as a prospective, randomized controlled trial between January 1, 2007 and December 31, 2011. Eligible inpatients at the Diabetic Foot Care Center of West China Hospital, Sichuan University (China) were randomly prescribed with a 12‐week standard treatment of ulcers (the control group) or standard treatment plus topical application APG (the APG group). The wound healing grades (primary endpoint), time to complete healing, and healing velocity within 12 weeks were monitored as short‐term effectiveness measurements, while side effects were documented safety endpoints. The rates of survival and recurrence within the follow up were recorded as long‐term effectiveness endpoints. Analysis on total diabetic ulcers (DUs) ( n = 117) and subgroup analysis on diabetic foot ulcers (DFUs) ( n = 103) were both conducted. Standard treatment plus APG treatment was statistically more effective than standard treatment ( p < 0.05 in both total DUs and subgroup of DFUs). The subjects defined as healing grade 1 were 50/59 (84.8%) in total DUs and 41/48 (85.4%) in DFUs in the APG group compared with 40/58 (69.0%) and 37/55 (67.3%) in the control group from intent to treat population. The Kaplan‐Meier time‐to‐healing were significantly different between the two groups ( p < 0.05 in both total DUs and subgroup of DFUs). No side effects were identified after topical APG application. The long‐term survival and recurrence rates were comparative between groups ( p > 0.05). This study shows that topical APG application plus standard treatment is safe and quite effective on diabetic chronic refractory cutaneous ulcers, compared with standard treatment.