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Role of local application of autologous platelet-rich plasma in the management of pressure ulcers in spinal cord injury patients

SINGH R; ROHILLA RK; DHAYAL RK; SEN R; SEHGAL PK
SPINAL CORD , 2014, vol. 52, n° 11, p. 809-816
Doc n°: 171378
Localisation : Centre de Réadaptation de Lay St Christophe

D.O.I. : http://dx.doi.org/DOI:10.1038/sc.2014.144
Descripteurs : AE21 - ORIGINE TRAUMATIQUE, DA451 - ESCARRES

The objective of this study is to evaluate the local application of platelet-rich plasma (PRP) in
relation to pressure ulcers (PrUs) healing on one PrU (case) versus saline
dressing on another PrU (control) in the same patient. SETTING: Tertiary Level
Care Centre, India. METHODS: Twenty-five spinal cord injury patients with at
least two PrUs were included. All 25 PrUs (case) were grade IV, and PrUs
(control) were grade II (n=11), grade IV (n=10) and grade III in 4 patients.
Evaluation of PrU healing was done by measuring wound surface area, Pressure
Ulcer Scale for Healing (PUSH), biopsy and clinical examination. RESULTS:
Statistically significant decrease in mean PUSH scores of PrUs (case) (t=6.13,
P<0.000) and PrUs (control) (t=3.98, P=0.000) was observed after 5 weeks. The
wound surface area of PrU (case) decreased significantly (t=4.98, P=0.000);
however, the decrease was not significant (t=0.095, P=0.924) in PrUs (control).
Majority of histopathological pictures of PrUs (case) showed necrosis and
suppuration (56%) at the time of enrollment and well-formed granulation tissue
and epithelialization (60%) at the 5th week. Twenty-four (96%) PrUs (case)
improved and only 1 deteriorated with PRP therapy, whereas in control group 17
(68%) PrUs improved, 7 (28%) deteriorated and 1 wound showed no change.
CONCLUSIONS: Advanced wound therapy using local applications of PRP seems to be a
promising alternative to standard saline dressings in PrU healing. With the
advantages of simple preparation, biocompatible safety, low cost and significant
clinical effectiveness, it may be beneficial to study the effects of PRP in
large-scale trials to validate it as an ideal therapy for enhanced wound healing
in PrUs.

Langue : ANGLAIS

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