title: Application of platelet-rich gel to enhance healing of transmetatarsal amputations in diabetic dysvascular patients.
abstract: Transmetatarsal amputation (TMA) represents an effective surgical procedure used to treat several clinical conditions such as forefoot infection, gangrene and chronic ulceration in diabetic patients. TMA permits walking without the need for prosthesis, but nevertheless is burdened with a high complications rate. The aim of this study was to evaluate the possibility to use platelet gel (PG) as an adjuvant therapy when performing TMA procedure in diabetic patients. In a 6-year period, 26 diabetic patients had undergone TMA procedure followed by autologous PG applications (group A) and 32 patients had undergone TMA as sole procedure (group B). After TMA procedure, the treatment is based on outpatient management and consists of a weekly platelet-rich plasma gel application on the surgical wound for 1 month in group A and on clinical evaluation only for group B. For group A, healing rate was of 96.15% and one patient (3.84%) presented wound dehiscence, and no postoperative wound infections occurred. For group B, healing rate was of 59.37%; severe infection of the stump prompted to the proximal amputations in 40.62% of patients during the follow-up period. PG application may be an effective adjuvant treatment to improve wound healing in diabetic dysvascular patients.
authors: Department of Surgical and Medical Science, University Magna Graecia of Catanzaro, Catanzaro, Italy.
authors: Raffaele
authors: R
authors: Serra
authors: Gianluca
authors: G
authors: Buffone
authors: Andrea
authors: A
authors: Dominijanni
authors: Vincenzo
authors: V
authors: Molinari
authors: Rossella
authors: R
authors: Montemurro
authors: Stefano
authors: S
authors: de Franciscis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D005260:Female; D005500:Follow-Up Studies; D016523:Foot Ulcer / Q000628:therapy*; D005782:Gels; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000601:surgery*; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
chemical_list: D005782:Gels
keywords: Diabetic foot; Diabetic patients; Platelet gel; Transmetatarsal amputation; Wound healing