Comparative Study between Negative Pressure Wound Therapy and Platelet Rich Plasma in Neovascularization of Chronic Wound Healing | ||||
The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
Article 7, Volume 42, Issue 1, January 2018, Page 35-43 PDF (10.86 MB) | ||||
Document Type: Research article | ||||
DOI: 10.21608/ejprs.2018.214975 | ||||
View on SCiNiTO | ||||
Authors | ||||
Ahmed G. El Nagar* 1; Ahmed A. M. Khalil2; Amira K. El Hawary3; Sami Sheba Eldin2; Ahmed M. Bahaa4 | ||||
1The Department of Plastic Surgery, Ahmed Maher Teaching Hospital, Cairo ; Egypt | ||||
2The Departments of Plastic Surgery, Faculty of Medicine, Mansoura University | ||||
3The Departments of Pathology Faculty of Medicine, Mansoura University | ||||
4The Departments of Plastic Surgery** , Faculty of Medicine, Mansoura University | ||||
Abstract | ||||
Background: Chronic wound healing is a significant health problem. Increased angiogenesis and blood flow had been shown to facilitate the healing of chronic wounds. Negative pressure wound therapy and platelet rich plasma may be used for treatment of various chronic wounds, especially when standard conventional therapy is not good enough or for preparation for definitive closure. Objectives: To compare the efficacy of negative pressure wound therapy and platelet rich plasma in neovascularization of chronic wound healing. Patient and Method: Twenty patients with chronic wound were divided into two groups. Wound tissue biopsies were collected from the centeraland peripheral of the wound before starting our procedure and after one, two and three weeks in both groups. Evaluation of the wound clinically and Immunohistochemically for vascular endothelial growth factor (VEGF) and CD31 (cluster of differentiation) were done. Results: PRP and NPWT were effective in neovasculization and stimulation of healing process. The expression of VEGF in PRP patients after the third week was mild 10%, moderate 20%, strong 70% and was mild 10%, moderate 20%, strong 70% in peripheral and central tissue biopsy respectively. While in NPWT patient was mild 20%, moderate 30%, strong 50% in both peripheral and central tissue biopsy. The average of blood vessels formation in CD-31 was 9.95±3.64 after 3 week in peripheral tissue biopsy and was 8.58±3.51 in central tissue biopsy in PRP patients. While in NPWT patients was 8.35±3.25 in peripheraltissue biopsy and was 8.38±3.12 in central tissue biopsy. Conclusion: PRP and NPWT are effective in treatment chronic wounds. PRP is more simple, less costly, shorter time for the method, less painful, no hospital stay and less transmission of infections. | ||||
Keywords | ||||
Wound; Platelet rich plasma; Healing | ||||
References | ||||
Hurd T., Chadwick P., Cote J., Cockwill J., Mole R. and Smith J.M.: Impact of gauze-based NPWT on the patient and nursing experience in the treatment of challenging wounds. International Wound Journal, 7 (6): 448-455, 2010. 2- Gupta S., Gabriel A., LantisJ. and Téot L.: Clinical recommendations and practical guide for negative pressure wound therapy with instillation. Int. Wound J., 13: 159- 174, 2016. 3- Masiero F.S. and Thyssen P.J.: Evaluation of conventional therapeutic methods versus maggot therapy in the evolution of healing of tegumental injuries in Wistar rats with and without diabetes mellitus. Parasitol Res., 115 (6): 2403- 2407, 2016. 4- Guo S.C., Tao S.C., Yin W.J., Qi X., Yuan T. and Zhang C.Q.: Exosomes derived from platelet-rich plasma promote the re-epithelialization of chronic cutaneous wounds via activation of YAP in a diabetic rat model, 7 (1): 81-96, 2017. 5- Ann H., Bart Landuyt, Martin S. Highley, Han Wildiers and Allan T. Van: Vascular Endothelial Growth Factor and Angiogenesis. Pharmacological Reviews, Vol. 56, (4): 549-580, 2004. 6- Johnson K. and Wilgus T.: Vascular Endothelial Growth Factor and Angiogenesis in the Regulation of Cutaneous Wound Repair. Advances in Wound Care, 3 (10): 647- 661, 2014. 7- Argenta L.C. and Morykwas M.J.: Vacuum-assisted closure: A new method for wound control and treatment: Clinical experience. Ann. Plast. Surg., 38 (6): 563-576; discussion 577, 1997. 8- Kairinos N., McKune A., Solomons M., Hudson D.A. and Kahn D.: The flaws of laser Doppler in negative-pressure wound therapy research. Wound Repair Regen, 22 (3): 424-429, 2014. 9- Pietrzark W. and Eppley B.: Platelet rich plasma: Biology and new technology. J. Cranio Facial Surg., 16 (6): 1043- 1054, 2005. 10- Andia I. and Abate M.: Platelet-rich plasma: Underlying biology and clinical correlates. Regen Med., 8 (5): 645- 658, 2013. 11- Nurden A.: Platelets, inflammation and tissue regeneration. Thromb Haemost, 105 (Supple 1): S13-33, 2011. 12- Kececi Y., Ozsu S. and Bilgir O.: A cost- effective method for obtaining standard platelet-rich plasma. Wound, 26 (8): 232-238, 2014. Egypt, J. Plast. Reconstr. Surg., January 2018 43 13- Gasbarro R: Negative pressure wound therapy: A clinical review. wounds: Compendium of clinical research and practice, 19 (12): 2-7, 2007. 14- Blanton M.W., Hadad I., Johnstone B.H., Mund J.A., Rogers P.I., Eppley B.L. and March K.L.: Adipose stromal cells and platelet-rich plasma therapies synergistically increase revascularization during wound healing. Plast. Reconstr. Surg., 123 (2 Supple): 56S-64S, 2009. 15- Han G. and Ceilley R.: Chronic Wound Healing: A Review of Current Management and Treatments. Adv. Ther., 1- 12, 2017. 16- Erba P., Ogawa R., Ackermann M., Adini A., Miele L.F., Dastouri P., Helm D., Mentzer S.J., D'Amato R.J., Murphy G.F., Konerding M.A. and Orgill D.P.: Angiogenesis in wounds treated by microdeformational wound therapy. Ann. Surg., 253 (2): 402-409, 2011. 17- Dini V., Miteva M., Romanelli Bertone M. and Romanelli M.: Immunohistochemical evaluation of venous leg ulcers before and after negative pressure wound therapy. Wounds, 23 (9): 257-266, 2011. 18- Wilcox J.R., Carter M.J. and Covington S.: Frequency of debridement and time to heal: A retrospective cohort study of 312-744 wounds. JAMA Dermatol., 149 (9): 1050- 1058, 2013. 19- Armstrong D.G. and Lavery L.A.: Diabetic Foot Study Consortium. Negative pressure wound therapy after partial diabetic foot amputation: A multicentrerandomized controlled trial. Lancet, 366 (9498): 1704-1710, 2005. 20- Yao M., Fabbi M., Hayashi H., Park N., Attala K., Gu G., French M.A. and Driver V.R.: A retrospective cohort study evaluating efficacy in high-risk patients with chronic lower extremity ulcers treated with negative pressure wound therapy. Int. Wound J., 11 (5): 483-488, 2014. 21- Lalezari S., Lee C.J., Borovikova A.A., Banyard D.A., Paydar K.Z., Wirth G.A. and Widgerow A.D.: Deconstructing negative pressure wound therapy. Int. Wound J., 2-3, 2016. 22- Frykberg R.G., Driver V.R., Carman D., Lucero B., Borris- Hale C., Fylling C.P., Rappl L.M. and Clausen P.A.: Chronic wounds treated with a physiologically relevant concentration of platelet-rich plasma gel: A prospective case series. Ostomy Wound Manage, 56 (6): 36-44, 2010. 23- Kakudo N., Kushida S., Ogura N., Hara T. and Suzuki K.: The use of autologous platelet rich plasma in the treatment of intractable skin ulcer. Open J. Reg. Med., 1 (3): 29-32, 2012. 24- Suthar M., Gupta S., Bukhari S. and Ponemone V.: Treatment of chronic non-healing ulcers using autologous platelet rich plasma: A case series. J. Biomed Sci., 24(1):16-26, 2017. 25- Danielsen P., Jorgensen B., Karlsmark T., Jorgensen L.N. and Agren M.S: Effect of Topical Autologous Platelet- Rich Fibrin versus No Intervention on Epithelialization of Donor Sites and Meshed Split-Thickness Skin Auto grafts: A Randomized Clinical Trial. Plastic and Reconstructive Surgery, 122 (5): 1431-1440, 2008. 26- Steenvoorde P., van Doorn L.P., Naves C. and Oskam J.: Use of autologous platelet rich fibrin on hard-to-heal wounds. J. Wound Care, 17: 60-63, 2008 | ||||
Statistics Article View: 151 PDF Download: 405 |
||||