ABSTRACT
Background: Chronic non-healing leg ulcers are a major health problem worldwide and have great impact on personal, professional and social levels, with high cost in terms of human and material resources. The present study was conducted with an aim to demonstrate the efficacy of autologous platelet rich plasma (PRP) in chronic non-healing leg ulcers in comparison to conventional dressings.Methods: A total of 50 patients with leg ulcers were randomized into two groups (A and B) with each group comprising of 25 patients each. Group A were treated with autologous platelet rich plasma (PRP) dressings and group B were treated with conventional dressings using normal saline. Ulcer measurements were taken on day 1, day 7, days 15 and after 30 days. The end point of study was complete wound epithelialization or appearance of granulation tissue, which ultimately lead to spilt skin grafting or secondary healing; whichever is earlier.Results: There was statistically significant difference in the average time taken for complete healing of ulcer in PRP dressings, 3.68 weeks against 6.2 weeks in conventional dressing group (p value <0.0001). PRP dressing group showed a 43.96% reduction in ulcer size as compared to 13.81% in conventional dressing group (p <0.0001). It was observed that PRP dressing group has faster wound healing and contraction of wound.Conclusions: PRP dressing of leg ulcers was better than conventional normal saline dressing as it leads to early reduction of ulcer size and enhances rate of wound healing.
ABSTRACT
Introduction: Mortality and morbidity following perforated peptic ulcer (PPU) remains high, and mortality proportions of 25–30% have been reported in population–based studies.The aim of this study was to evaluate the efficacy of PULP SCORE in predicting 30 day mortality. Patients and methods: A series of 52 patients were enrolled in the study.Patients who underwent surgical treatment for perforated peptic ulcer were allotted points according to the PULP scoring system and stratified into high and low risk groups. All the data was prospectively analyzed. Observations and results:46 patients were in low risk and 6 patients were in high risk category. 5 patients were deceased in high risk group but none in low risk group. The PULP SCORE had a sensitivity of 83.33% and specificity of 97.83% in predicting mortality. In the ROC curve the AUC was 91.8%. 4 variables out of 8 variables in the score were found to be most important in predicting mortality. They were : 1. Treatment delay >24 hrs, 2. Shock on admission, 3. High ASA score, 4. Age >65 years. Conclusion:The prognostic predictors included in the PULP score can be readily identified prior to surgery, easy to use and feasible in emergency. The PULP score can assist in accurate and early identification of high–risk patients, and thus assist in risk stratification and triage of patients.