title: Autologous platelet rich plasma in the management of non-healing vasculitic ulcers.
abstract: OBJECTIVE
  To determine the role and efficacy of platelet rich plasma (PRP) in the healing of recalcitrant vasculitic ulcers and to study the rapidity of ulcer healing with respect to platelet concentration in the prepared PRP.
  
  
  METHODS
  This is a pilot study which included 20 patients with biopsy-proven vasculitic ulcers after excluding human immunodeficiency virus, uncontrolled diabetes mellitus, hypertension, obesity, active smoking and platelet abnormalities in peripheral smear. PRP was prepared from whole blood by centrifugation and activated using 10% calcium chloride. Activated PRP was applied over the ulcer by spraying using a syringe. Weekly dressing was done until the ulcer healed and healing was monitored using the Leg Ulcer Measurement Tool (LUMT).
  
  
  RESULTS
  The total number of patients were 20 (male four; female 16). The mean age was 34.5 ± 15.36 years (2.0 SD). Mean duration of illness was 8.6 ± 2.9 months(2.0 SD). Ulcers were located in the lower third of the leg (n = 13), ankle (n = 4) and foot (n = 3) in the descending order of frequency. On average, epithelization of the wound occurred at 4.4 weeks. Faster healing was seen in mixed connective tissue disease (average 3.5 weeks) and delayed healing in systemic lupus erythematosus (average 4.7 weeks). Average platelet count obtained in the PRP was 5.52 lakhs/mm3to 18.6 lakhs/mm3with an increase in platelet count of 3.4- to 6-fold, respectively. Duration of healing corresponded with the platelet concentration in the prepared PRP. All the 20 patients showed complete healing within 6 weeks.
  
  
  CONCLUSIONS
  PRP is a safe, effective, outpatient procedure for the treatment of chronic recalcitrant vasculitic ulcers which improves the quality of life of patients and reduces their financial burden.
authors.affiliation: Institute of Rheumatology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India.
authors.forename: Sankaran
authors.initials: S
authors.lastname: Sriram
authors.affiliation: Institute of Rheumatology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India.
authors.forename: Rajeswari
authors.initials: R
authors.lastname: Sankaralingam
authors.affiliation: Institute of Rheumatology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India.
authors.forename: Madeshwaran
authors.initials: M
authors.lastname: Mani
authors.affiliation: Institute of Rheumatology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India.
authors.forename: Tiruchengode Natesan
authors.initials: TN
authors.lastname: Tamilselvam
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001458:Bandages; D001706:Biopsy; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010976:Platelet Count; D053657:Platelet-Rich Plasma; D011788:Quality of Life; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014657:Vasculitis / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult
keywords: Leg Ulcer Measurement Tool; growth factors; platelet rich plasma; vasculitic ulcer