Effectiveness of platelet releasate for the treatment of diabetic neuropathic foot ulcers.
OBJECTIVE
The goal of this study was to specifically estimate the effectiveness of platelet releasate, a widely available treatment administered by a proprietary group of wound care centers (WCCs) for the treatment of diabetic neuropathic foot ulceration.


METHODS
Treatment effectiveness was estimated in a retrospective cohort study controlling for treatment selection bias using logistic regression-derived propensity scores.


RESULTS
Platelet releasate was more effective than standard care. The relative risk for a wound to heal after treatment with platelet releasate compared with standard care at a WCC varied from 1.14 (95% CI 1.03-1.27) to 1.59 (1.49-1.70). The effect was greatest in those with the most severe wounds, i.e., large wounds that affect deeper anatomical structures.


CONCLUSIONS
Within the limitations of the ability of propensity score analysis to control for selection bias, platelet releasate is more effective than standard therapy. This effect is more pronounced in more severe wounds. Unfortunately, severe wounds have not been evaluated in randomized clinical trials of new interventions. We encourage the inclusion of these patients in future trials.
Margolis
D J
DJ
Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia 19104, USA. dmargoli@cceb.med.upenn.edu
Kantor
J
J
Santanna
J
J
Strom
B L
BL
Berlin
J A
JA
D000368:Aged; D001792:Blood Platelets / Q000378:metabolism / Q000502:physiology*; D015331:Cohort Studies; D016208:Databases, Factual; D017719:Diabetic Foot / Q000188:drug therapy*; D003929:Diabetic Neuropathies / Q000188:drug therapy*; D005260:Female; D006133:Growth Substances / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010982:Platelet-Derived Growth Factor / Q000627:therapeutic use*; D012189:Retrospective Studies; D014945:Wound Healing / Q000187:drug effects*
D006133:Growth Substances; D010982:Platelet-Derived Growth Factor