Clinical Outcome of Chronic Leg and Foot Ulcers Treated with Autologous Platelet Rich Fibrin

BACKGROUND Chronic leg and foot ulcers are a major health problem and leads to negative physical, social and psychological impact on patients and families. A high percentage of chronic ulcers do not adequately heal or quickly relapse with conventional treatment. They need advanced treatment modalities. Emerging cellular therapies such as platelet-rich concentrate therapy is an advanced modality. Platelet rich fibrin (PRF) is a second-generation platelet concentrate, consists of fibrin three-dimensional polymerized matrix, with the incorporation of platelets and leukocytes. The objective of the study was to assess clinical outcome of chronic leg and foot ulcers treated with autologous platelet rich fibrin. METHODS This prospective study included 30 patients with chronic leg or foot ulcers of various aetiologies, 19 patients had diabetic foot ulcers, 7 venous ulcers, 1 trophic ulcer, 2 pressure ulcers and 1 traumatic ulcer. Autologous PRF treatment outcome was measured by percentage of improvement in area and volume of the ulcer. We also studied other ulcer characteristics including exudate type, pus culture and sensitivity status, presence of undermining, type of tissue in ulcer bed and comorbidities. RESULTS From the 30 ulcers treated with PRF, the mean percentage of improvement in area and volume of ulcers were 98.3% and 98.8% respectively at the end of 2 months. 80% ulcers healed completely. There was also reduction of pain and exudate after first week of treatment. Other than increased callus formation in some ulcers, no other adverse events were reported following PRF treatment. CONCLUSIONS PRF is a safe, easy-to-use, cost-effective treatment method with significant potential for healing chronic ulcers. KEY WORDS PRF-Platelet Rich Fibrin