title: [Impact of topical application of autologous platelet-rich gel on medical expenditure and length of stay in hospitals in diabetic patients with refractory cutaneous ulcers].
abstract: OBJECTIVE
  To evaluate the potential financial benefit of topical application of autologous platelet-rich gel (APG) in treating diabetic refractory cutaneous ulcers.
  
  
  METHODS
  A single-center prospective randomized controlled trial was undertaken, with 117 patients with proven diabetic refractory cutaneous ulcers participating in the study. The patients who gave informed consents were randomly assigned into standard care group (n = 58) or standard care plus topical application of APG treatment group (n = 59). The outcome of healing and the medical expenditur and length of stay in the patients were compared between the two groups.
  
  
  RESULTS
  The APG-treated group had better healing outcomes than the standard-treated group. The APG-treated group had 84.750 (50/59) complete healing and 98.31% improvement, higher than the 68.97% (40/58) and 75.86%, respectively, in the standard-treated group (P = 0.026). The median length for healing in the APG-treated patients was 36 days, shorter than the 45 days in the standard-treated patients (P = 0.012). The total medical expenditure and length of stay in hospitals were not significantly different between APG-treated patients [yen 38223 (23070-57398); 57 (41-94) days] and standard-treated patients [yen 35070 (24436-53649); 58 (31.75-58.50) days) (P = 0.455 and 0.301 respectively). Spendings on items such as medicine, artificial treatment, materials, interventional operation, surgical procedures, laboratory tests and other auxiliary examination, accommodations, meals, nursing care and debridement and dressing change were similar between the two groups (P > 0.05).
  
  
  CONCLUSIONS
  There is an advantage for the topical application of APG on diabetic refractory cutaneous ulcers in terms of the healing outcomes. APG is a cost-effective choice for patients with diabetic refractory cutaneous ulcers.
authors.affiliation: Diabetic Foot Care Center, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Li
authors.forename: Chun
authors.initials: C
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: He
authors.forename: Yan-Zhi
authors.initials: YZ
authors.lastname: Yang
authors.forename: Li-Hong
authors.initials: LH
authors.lastname: Chen
authors.forename: Da-Wei
authors.initials: DW
authors.lastname: Chen
authors.forename: Xiu-Jun
authors.initials: XJ
authors.lastname: Li
authors.forename: Xing-Wu
authors.initials: XW
authors.lastname: Ran
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D048909:Diabetes Complications / Q000378:metabolism / Q000628:therapy*; D017719:Diabetic Foot / Q000191:economics* / Q000378:metabolism / Q000628:therapy; D005260:Female; D005782:Gels / Q000191:economics; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000379:methods; D053657:Platelet-Rich Plasma / Q000502:physiology; D011446:Prospective Studies; D012883:Skin Ulcer / Q000191:economics* / Q000209:etiology / Q000628:therapy; D014945:Wound Healing
chemical_list: D005782:Gels