Management of Wounds of Peripheral Arterial Disease Using Platelet Rich Plasma.

ABSTRACT

Arterial ulcers are caused by inadequate perfusion of skin and subcutaneous tissues. The key treatment is correcting the underlying medical problem and re-perfusion of the affected tissue. Interventional procedures like angiography, transluminal angioplasty, and stenting have hazards like bleeding, hematoma formation, false aneurysm formation etc. This study was conducted to investigate the effect of platelet-rich plasma (PRP) on the rate of healing of peripheral arterial wounds. MethodsA randomized controlled trial was conducted with 80 participants admitted with peripheral arterial disease in Acharya Vinoba Bhave Rural Hospital, Wardha district, Maharashtra, from September 2017 - August 2019. Data was entered into MS Excel and was analysed for descriptive statistics. 40 patients each were allotted randomly to control group and treatment group. In the control group, conventional dressings was done with hydrogen peroxide and betadine. Wounds were treated with PRP infiltration in the treatment group. Outcome was compared between both groups. ResultsMean surface area of wound in control group reduced from baseline 2262.5 mm2 to 1758.4 mm2 (29.89% reduction) in ulcer surface area, and 2298.9 mm2 to 1158.1 mm2 (66.22% reduction) in treatment group (p= 0 at the end of study) at the end of two months. Standard deviation of the same (Control 1739.2 mm2 to 1566.3 mm2 vs Treatment 1906.5 mm2 to 1402.4 mm2). Rate of epithelization was faster in treatment group (8.92 mm2/day vs 17.27 mm2/day, p=0 at the end of study). PRP resulted in early healing of ulcers with earlier reduction in wound surface area. ConclusionsPRP is an effective method for healing of wounds resulting from peripheral arterial disease.