Randomised double-blind placebo controlled trial of topical autologous platelet lysate in venous ulcer healing.

OBJECTIVES: to assess the effect of topical autologous platelet lysate on the healing of chronic venous ulcers. DESIGN: a randomised placebo controlled double-blind trial. MATERIALS: all patients had blood taken for preparation of autologous platelet lysate. METHODS: patients with proven chronic venous ulceration were randomised to the trial. Autologous platelet lysate or placebo buffer solution were applied twice per week for up to 9 months in combination with standardised compression bandaging. RESULTS: a total of 86 patients (36 males and 50 females, median age 70 years) were entered into the study. The patient and treatment groups were equivalent for ulcer size, ulcer duration and other characteristics. Cox regression analysis of the time to ulcer healing did not show any difference in healing between platelet lysate and placebo application. CONCLUSIONS: platelet lysate prepared and delivered by the method used in this study had no influence on the healing of chronic venous ulceration.

Lower levels of PAI-2 may contribute to impaired healing in venous ulcers - a preliminary study.

Plasminogen activators may potentially influence the wound healing processes of cell migration, matrix degradation and cellular adhesion in venous ulcers by their regulation of protease activity. The aim of this study was to assess the levels of plasminogen activators in venous ulcers and to gain preliminary data from healing wounds. The concentrations of u-PA, t-PA, PAI-1 and PAI-2 antigen as well as functional u-PA were assessed in tissue homogenates from 20 chronic venous ulcers, six actively healing venous ulcers and five traumatic wounds. The concentrations of functional u-PA, u-PA antigen and PAI-1 were significantly greater and PAI-2 was significantly lower in the edge and base of chronic venous ulcers compared to adjacent intact skin (P<0.01). Healing wounds had significantly higher functional u-PA at the ulcer edge and higher u-PA antigen concentration in intact skin (P<0.05). PAI-2 levels were significantly higher in the ulcer edge and base in the healing wounds than in chronic venous ulcers (P<0.05). These findings suggest that regulation of protease activity by u-PA and PAI-2 may play a role in the impaired healing of chronic venous ulcers.