CONTAMINATED PROBLEMATIC SKIN WOUNDS IN DIABETIC PATIENTS TREATED WITH AUTOLOGOUS PLATELET - RICH PLASMA (PRP): A case series study.

OBJECTIVE: To study the effect of platelet-rich plasma (PRP) on contaminated problematic skin ulcers in patients with diabetes. MATERIAL AND METHODS: A total of 6 patients had been treated within the period from 2012 to 2014; they had various types of problematic wounds and diabetes type 2. Patients' distribution by sex was as follows: 1 man and 5 women; mean age-68 years. Ulcer types: acute (2 patients), hard-to-heal (2 patients) and chronic (2 patients) ulcers. The mean size of the skin and soft tissue defect was 9,5 cm(2). Pathogenic microflora was isolated in 4 patients S. aureus in three and E. coli in one. Based on a scheme developed by us, all cases were treated by administering platelet-rich plasma, derived by PRGF Endoret system. Follow- up period was within 4 - 6 months (4,5 on average). We used platelet rich plasma derived by PRGF Endoret system, applied on the wound bed on a weekly basis. RESULTS: Application of PRP allowed successful closure of all wounds. There were no complications associated with treatment of PRP. Epithelialization of the wound took 15 weeks on average for all patients. One patient presented with hyperkeratosis. Initial score of followed wounds, based on the scales are as follows: Total wound score - 10 p. Total anatomic score - 8 p. Total score - 15 p. at the initial stage. At the end of the treatment period scores were as follows - 0 p., which means excellent results CONCLUSION: We believe that the application of PRP may become optimal therapy in the treatment of contaminated problematic wounds in diabetic patients. PRP not only stimulates wound healing, but also has antimicrobial properties, which may contribute to the prevention of infections.