Randomized prospective comparative study of platelet-rich plasma versus conventional compression in treatment of post-phlebitic venous ulcer

Platelet-rich plasma and plasma rich in growth factors in extra-oral wound care

This narrative review evaluates the existing literature on the clinical efficacy and safety of platelet-rich plasma (PRP) and plasma rich in growth factors (PRGFs) in extra-oral wound care, considering their potential benefits and drawbacks. The review specifically focuses on the impact of these treatments on patients' quality of life, pain management, treatment costs, recurrence rates, and potential complications. Given the extensive literature and diverse range of extra-oral wound types in which these autologous platelet concentrates have been applied, this narrative review focuses on the most frequently described wound types, including diabetic foot ulcers, venous leg ulcers, pressure ulcers, surgical wounds, and burns. The use of PRP has been reported in various medical specialties, with a low risk of adverse events. While there is a growing interest in the use of PRGF with promising results, the available literature on this topic is still limited. Only a few studies evaluated patients' perception of the treatment and the relationship between treatment costs and clinical outcomes. Data on recurrence rates and complications also vary across studies. In conclusion, PRP and PRGF show promise as alternatives or as adjunctive therapies to conventional treatments for various extra-oral wounds and ulcers, leading to reduced wound size and accelerated healing time but should be considered on a case-by-case basis, taking into account the type and severity of the wound.

Efficacy and safety of platelet-rich plasma in the treatment of venous ulcers: A systematic review and meta-analysis of randomized controlled trials

Considering the substantial impact of venous ulcers on quality of life and healthcare systems, this study evaluated the efficacy and safety of platelet-rich plasma (PRP) in comparison to conventional therapy. A systematic review of four databases identified 16 randomized clinical trials, including 20 study groups. PRP significantly enhanced complete ulcer healing, exhibiting an odds ratio (OR) of 5.06 (95% confidence interval [CI]: 2.35-10.89), and increased the percentage of healed ulcer area by a mean difference of 47% (95% CI: 32%-62%). Additionally, PRP shortened the time required for complete healing by an average of 3.25 months (95% CI: -4.06 to -2.43). Although pain reduction was similar in both groups, PRP considerably decreased ulcer recurrence rates (OR = 0.16, 95% CI: 0.05-0.50) without increasing the risks of infection or irritative dermatitis. These results suggest PRP as a viable, safe alternative for venous ulcer treatment, providing significant improvements in healing outcomes.

Chronic Venous Insufficiency With Emphasis on the Geriatric Population

The underpinning of Chronic Venous Insufficiency (CVI) is valvular dysfunction, which manifests on a spectrum depending on the severity of insufficiency and duration of the disease. The mainstay of treatment relies on compression therapy of a proper type and intensity. In older adults, special consideration must be taken during the patient encounter to account for age-related factors. This review discusses the clinical presentation, diagnosis, and mimicking of CVI, focusing mainly on older adults. The epidemiology, risk factors, disease burden, and grave complications -- such as thrombosis and ulceration, are reviewed. The physiological impacts of CVI are described, providing the background for treatment strategies, including non-invasive, medical, and surgical therapies. The findings show advanced age to be an important risk factor contributing to CVI and that other age-related factors add to the risk of severe complications. Clinical assessments combined with objective measurements that assess localized skin water using tissue dielectric constant values or whole limb assessments may aid in the differential diagnosis. Furthermore, understanding the mechanism of action of compression therapy, the mainstay of CVI treatment, and its physiological impacts, allows for its informed use in geriatric patients with increased risks of potential compression-related side effects.