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

Abstract

Background: Necrotic tissues debridement, revascularization surgery, infection control, mechanical offloading, bloodglucose monitoring, and patient education are the standard treatments for persistent diabetic foot ulcers. Platelet-richfibrin has positive benefits in the stomatology fields. Leukocyte-PRF aids in soft tissue healing, bone regeneration andrich in growth factors.Aim & Objectives: This study measured changes in wound area and documented adverse events to evaluate the efficacyof 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 enrolledin prospective quasi-experimental study. The patients' ulcers did not heal even after receiving the best possible woundcare, which included appropriate offloading, daily dressing and proper control of infection. For six weeks, L-PRF appliedtopically to each patient once every five to seven days, either as an injectable and/or membrane form. Following eachsession, diameters of the ulcers were measured and recorded and carefully examined if there were any signs of infectionor 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 correlationbetween the change in ulcer length vs. the change in ulcer width and strong positive correlation between ABPI vs. Thechange in ulcer depth. It also shows a marginally significant negative correlation of moderate strength between the changein ulcer length vs. the hemoglobin A1c percentage and marginally significant positive correlation of moderate strengthbetween 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 diabeticfoot ulcers. It is a speedy, affordable, and accessible modality.