title: Exploratory clinical trial of combination wound therapy with a gelatin sheet and platelet-rich plasma in patients with chronic skin ulcers: study protocol.
abstract: BACKGROUND
  Chronic skin ulcers, such as diabetic ulcers, venous leg ulcers and pressure ulcers, are intractable and increasing in prevalence, representing a costly problem in healthcare. We developed a combination therapy with a gelatin sheet, capable of providing sustained release of platelet-rich plasma (PRP). The objective of this study is to investigate the safety and efficacy of autologous PRP covered with a hydrocolloid dressing and PRP covered with a gelatin sheet in the treatment of chronic skin ulcers.
  
  
  METHODS
  Thirty patients with chronic skin ulcers who have not healed with conventional therapy for at least 1 month are being recruited. The patients will receive PRP after debridement, and the wounds will be covered with a hydrocolloid dressing or gelatin sheet. The efficacy will be evaluated according to the time from the beginning of PRP application to secondary healing or the day on which wound closure is achieved with a relatively simple surgical procedure, such as skin grafting or suturing. All patients will be followed up until 6 weeks after application to observe adverse events related to the application of PRP and the dressings. This study was designed to address and compare the safety and efficacy of PRP covered with a hydrocolloid dressing versus a gelatin sheet. If successful, this combination therapy may be an alternative to bioengineered skin substitutes containing living cells and lead to substantial progress in the management of chronic skin ulcers.
  
  
  BACKGROUND
  The study protocol was approved by the Institutional Review Board of Kansai Medical University (KMU Number 0649-1, 4 August 2014: V.1.0). The findings of this trial will be disseminated through peer-reviewed journals, and national and international scientific meetings as well as to the patients.
  
  
  BACKGROUND
  UMIN000015689.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Morimoto
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Kakudo
authors.affiliation: Department of Biomaterials, Field of Tissue Engineering, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Matsui
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan.
authors.forename: Tsunetaka
authors.initials: T
authors.lastname: Ogura
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hara
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Biomaterials, Field of Tissue Engineering, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Biomaterials, Field of Tissue Engineering, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tabata
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kusumoto
mesh_terms: D000328:Adult; D001458:Bandages; D002908:Chronic Disease; D005260:Female; D005780:Gelatin / Q000737:chemistry / Q000627:therapeutic use*; D006801:Humans; D020100:Hydrogels / Q000627:therapeutic use; D008297:Male; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D012883:Skin Ulcer / Q000628:therapy*; D014945:Wound Healing
chemical_list: D020100:Hydrogels; D005780:Gelatin
keywords: PLASTIC & RECONSTRUCTIVE SURGERY; WOUND MANAGEMENT