title: A pilot study on the effectiveness of platelet-rich plasma and debridement for the treatment of nonhealing fistulas in spinal cord-injured patients.
abstract: OBJECTIVE
  To determine the effectiveness of platelet-rich plasma (PRP) in the treatment of nonhealing fistula in spinal cord-injured patients.
  
  
  METHODS
  This was a pilot study of 15 spinal cord-injured patients with chronic pressure ulcers (PrUs) and nonhealing fistulas treated with PRP.
  
  
  METHODS
  Germany, Rheinland Pfalz, BG Trauma Center Ludwigshafen
  
  
  METHODS
  The authors treated 15 patients with PRP who had nonhealing fistulas due to multiple surgical closures of PrUs. According to the National Pressure Ulcer Advisory Panel's stages, 12 patients had Stage III PrUs, and 3 patients had Stage IV PrUs.
  
  
  RESULTS
  After 1 week of treatment with PRP, the authors observed low levels of secretion from the fistulas. After 2 weeks, they noted no further secretion from the fistulas. A magnetic resonance imaging control investigation after 3 weeks showed the complete disappearance of the fistulas. No negative effects and no allergic reactions were noted in the use of PRP.
  
  
  CONCLUSIONS
  The authors' results suggest that the application of PRP in combination with debridement is an effective therapy option and good alternative to recurrent surgical interventions for treating nonhealing fistulas resulting from the surgical closure of PrUs.
authors: Bahram Biglari, MD, is Chief Physician, Department of Paraplegiology, Ludwig-Guttmann-Str, Heidelberg, Germany. Tim Reitzel, MD, is a Physician, Department of Paraplegiology, BG Trauma Center, Ludwig-Guttmann-Str, Ludwigshafen, Germany. Tyler Swing is a Medical Student, Trauma and Reconstructive Surgery, Department of Orthopedics, Trauma Surgery and Paraplegiology, Heidelberg University Hospital, Germany. Axel Büchler, MD, is a Physician; Hans Jürgen Gerner, MD, is a Physician and Professor; Gerhard Schmidmaier, MD, is a Physician and Professor; and Arash Moghaddam, MD, is a Physician, all at Trauma and Reconstructive Surgery, Department of Orthopedics, Trauma Surgery and Paraplegiology, Heidelberg University Hospital.
authors: Bahram
authors: B
authors: Biglari
authors: Tim
authors: T
authors: Reitzel
authors: Tyler
authors: T
authors: Swing
authors: Axel
authors: A
authors: Büchler
authors: Hans Jürgen
authors: HJ
authors: Gerner
authors: Gerhard
authors: G
authors: Schmidmaier
authors: Arash
authors: A
authors: Moghaddam
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods*; D005260:Female; D005402:Fistula / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D053657:Platelet-Rich Plasma; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D003668:Pressure Ulcer / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D018570:Risk Assessment; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*