Effectiveness of autologous leucocyte and platelet-rich fibrin (L-PRF) in management of chronic diabetic foot ulcers.

Document Type : Original Article

Authors

1 Department of Vascular Surgery, Faculty of Medicine, Mansoura University, Egypt

2 Department of General Surgery, Faculty of Medicine, Mansoura University, Egypt

Abstract

Background: Necrotic tissues debridement, revascularization surgery, infection control, mechanical offloading, blood
glucose monitoring, and patient education are the standard treatments for persistent diabetic foot ulcers. Platelet-rich
fibrin has positive benefits in the stomatology fields. Leukocyte-PRF aids in soft tissue healing, bone regeneration and
rich in growth factors.
Aim & Objectives: This study measured changes in wound area and documented adverse events to evaluate the efficacy
of L-PRF administration in the treatment of chronic diabetic foot ulcers.
Patients and Methods: Twenty patients with persistent diabetic foot ulcers lasting longer than three months were enrolled
in prospective quasi-experimental study. The patients' ulcers did not heal even after receiving the best possible wound
care, which included appropriate offloading, daily dressing and proper control of infection. For six weeks, L-PRF applied
topically to each patient once every five to seven days, either as an injectable and/or membrane form. Following each
session, diameters of the ulcers were measured and recorded and carefully examined if there were any signs of infection
or newly formed ulcers on the foot.
Results: There was a statistically significant decrease in all three ulcer dimensions, length (p=.002), width (p=<.001),depth
(p=.020) after 6 weeks and the surface area (p=<.001) . There was a statistically significant strong positive correlation
between the change in ulcer length vs. the change in ulcer width and strong positive correlation between ABPI vs. The
change in ulcer depth. It also shows a marginally significant negative correlation of moderate strength between the change
in ulcer length vs. the hemoglobin A1c percentage and marginally significant positive correlation of moderate strength
between the change in ulcer length vs. the change in ulcer depth .
Conclusion: The use of L-PRF can lower the burden of the illness and greatly accelerate the healing of chronic diabetic
foot ulcers. It is a speedy, affordable, and accessible modality.

Keywords

The Egyptian Journal of Surgery
Volume 43, Issue 4
October 2024
Pages 1540-1547

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