title: Effectiveness of Platelet-Rich Plasma to Enhance Healing of Diabetic Foot Ulcers in Patients With Concomitant Peripheral Arterial Disease and Critical Limb Ischemia.
abstract: We sought to investigate the effect of autologous platelet-rich plasma (PRP) on the healing rate of diabetic foot ulcers in patients with diabetes and concomitant peripheral arterial disease (PAD). Diabetic patients with foot ulceration presenting with PAD who were treated with local growth factors in a single center, during a 24-month period from May 2009 to April 2011, were retrospectively reviewed. Based on the severity of PAD, subjects were divided into groups A (Fontaine classification stages I, IIa, and IIb) and B (Fontaine classification stages III and IV), with those included in the latter being considered to suffer from critical limb ischemia (CLI). End points of the analysis were clinical improvement, limb salvage, and amputation rate. Outcome was compared between groups A and B. Overall, 72 patients were evaluated, 30 with CLI. Ulcer area reduction >50% was observed in 58/72 patients while reduction >90% was achieved in 52/72 patients. There were 14 (19%) major and minor amputations, whereas the limb salvage rate was 89%. This variable was significantly different between groups A and B (100% vs. 73%, P < .001), as is rate of reduction in ulcer area >90% (83% vs. 56%, P = .02). Reduction of ulcer area >50% was observed in the majority of patients in both groups (group A 86% vs. group B 73%, P = .23). In conclusion, PRP could serve as a useful adjunct during management of diabetic foot ulcers even in diabetic patients with unreconstructable arterial disease.
authors: University of Crete Medical School, Heraklion, Greece kontopodisn@yahoo.gr.
authors: Nikolaos
authors: N
authors: Kontopodis
authors: University of Crete Medical School, Heraklion, Greece.
authors: Emmanouhl
authors: E
authors: Tavlas
authors: University of Crete Medical School, Heraklion, Greece.
authors: George
authors: G
authors: Papadopoulos
authors: University of Crete Medical School, Heraklion, Greece.
authors: Dimitrios
authors: D
authors: Pantidis
authors: University of Crete Medical School, Heraklion, Greece.
authors: Alexandros
authors: A
authors: Kafetzakis
authors: University of Crete Medical School, Heraklion, Greece.
authors: George
authors: G
authors: Chalkiadakis
authors: University of Crete Medical School, Heraklion, Greece.
authors: Christos
authors: C
authors: Ioannou
mesh_terms: D000368:Aged; D016638:Critical Illness; D017719:Diabetic Foot / Q000150:complications* / Q000628:therapy*; D005260:Female; D016523:Foot Ulcer / Q000150:complications* / Q000628:therapy*; D006801:Humans; D007511:Ischemia / Q000150:complications*; D007866:Leg / Q000098:blood supply*; D008297:Male; D058729:Peripheral Arterial Disease / Q000150:complications*; D053657:Platelet-Rich Plasma; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing
keywords: amputation rate; growth factors; limb salvage; ulcer healing