Tissue regeneration in loss of substance on the lower limbs through use of platelet-rich plasma, stem cells from adipose tissue, and hyaluronic acid.
BACKGROUND
Platelet-rich plasma (PRP) induces wound regeneration and tissue repair through cell proliferation and differentiation, promoting tissue healing and also acting as an autologous scaffold. With a small quantity of blood, it is possible to obtain the necessary optimal volume of PRP to treat the loss of substance in the lower limb. It has been demonstrated that mesenchymal stem cells are present in the adipose tissue (thus accelerating the effect of the PRP).


METHODS
The analysis involved 30 patients with lesions ranging from ulcerative, dystrophic, with substance loss, with differentiating etiopathogenesis all localized on the inferior limb, and to those treated with PRP and autologous fat grafts. The wounds were covered with a 3-dimensional, polymerized hyaluronic acid medicated biologic dressing. The authors' protocol consists of a general checkup; wound examination; instrumental, microbiological, and immunohistochemical diagnostic examinations; and acquisition of photographic images with follow-up at 0, 1, 2, and 3 weeks; 1, 3, and 6 months; and 1 year.


RESULTS
The results show an improvement from minor to moderate in 100% of patients after 3 weeks, healing in less than 6 weeks in 47% of patients, and complete wound healing in 57% of patients within 3 months.


CONCLUSIONS
The authors' data demonstrate the ability of the combination of PRP and autologous adipose graft to regenerate tissue and epithelialization with wound closure, with a significant healing-time reduction. Furthermore, the minimally invasive technique is well accepted by patients, with a noteworthy improvement of the quality of life along with cost reduction due to the fewer number of medications.
Cervelli
Valerio
V
Department of Plastic and Reconstructive Surgery, University of Tor Vergata, Rome, Italy.
De Angelis
Barbara
B
Lucarini
Lucilla
L
Spallone
Diana
D
Balzani
Alberto
A
Palla
Ludovico
L
Gentile
Pietro
P
Cerulli
Paolo
P
D000273:Adipose Tissue / Q000166:cytology / Q000637:transplantation; D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002454:Cell Differentiation; D049109:Cell Proliferation; D064987:Cell- and Tissue-Based Therapy; D005260:Female; D048091:Guided Tissue Regeneration / Q000379:methods*; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D007869:Leg Injuries / Q000628:therapy*; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D003668:Pressure Ulcer / Q000628:therapy; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous; D014945:Wound Healing
D000276:Adjuvants, Immunologic; D006820:Hyaluronic Acid