title: Wounds Difficult to Heal: An Effective Treatment Strategy.
abstract: OBJECTIVE
  Treatment of wounds difficult to heal concerns 50% of the elderly population in Italy and is therefore a relevant social burden. The present study shows how the treatment with autologous leuco-platelets reduces the healing time of wounds improving the functional recovery.
  
  
  METHODS
  Patients (n=100) with ulcers of the legs were divided in two groups: 1) 50 patients treated with conventional therapies; 2) 50 patients treated with autologous leuco-platelet concentrate (LPC) and hyaluronic acid (HIAFF, Hyalofill-F® ) as a scaffold.
  
  
  RESULTS
  After 2 months, a 49% reduction in wound area was observed in the second group and in about 65% wound reduction was achieved in 15 days (4 LPC dressings). In contrast, patients treated by conventional therapies, showed a longer healing time and a greater percentage of failures. Morphometric analysis of biopsy samples obtained from the edge as well as from the bottom of the lesions obtained from the LPC group, detected an abundant presence of neoformed capillaries, characterized by a cubic, "reactive endothelium", close to the site of LPC infiltration.
  
  
  CONCLUSIONS
  These results suggest that healing was promoted not only by limiting bacterial infections but also by the release of chemotactic and proangiogenic factors from leukocytes and platelets, improving the neoformation of capillaries.
authors.affiliation: Department of Surgical Sciences. Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Capoano
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Rome. Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Businaro
authors.affiliation: Department of Surgical Sciences. Italy.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Tesori
authors.affiliation: Department of Surgical Sciences. Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Donello
authors.affiliation: Department of Surgical Sciences. Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Lombardo
authors.affiliation: Department of Sensory Organs. Italy.
authors.forename: Vincenza Rita
authors.initials: VR
authors.lastname: Lo Vasco
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies. Italy.
authors.forename: Lorena
authors.initials: L
authors.lastname: Capriotti
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies. Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Corsi
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies. Italy.
authors.forename: Tania
authors.initials: T
authors.lastname: Di Raimo
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies. Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Leopizzi
authors.affiliation: Department of Surgical Sciences. Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Salvati
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, Rome. Italy.
authors.forename: Serafino
authors.initials: S
authors.lastname: Ricci
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D001792:Blood Platelets / Q000502:physiology*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000494:pharmacology; D007558:Italy; D007871:Leg Ulcer / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000187:drug effects; D054457:Tissue Scaffolds; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D006820:Hyaluronic Acid
keywords: Wound healing; hyaluronic acid; leuco-platelet concentrate; leukocytes; morphometry; neoangiogenesis