Comparative Study between Platelet-rich Plasma, Platelet-derived Growth Factor Gel, and Normal Saline Dressing in Chronic Ulcer Healing.

Abstract

Background: Chronic ulcers pose significant challenges in clinical management due to their prolonged healing time and high recurrence rates. Various treatment modalities have been explored to enhance the healing process. Among these, platelet-rich plasma (PRP) and platelet-derived growth factor (PDGF) gel have shown promising results due to their regenerative properties. This study aims to compare the efficacy of PRP, PDGF gel, and normal saline dressing in the healing of chronic ulcers, focusing on wound shrinkage, healing duration, and complication rates.

Aim: The aim of the study was to study and compare the efficacy of PRP, PDGF dressings, and normal saline dressings in chronic nonhealing ulcers.

Materials and methods: The study was conducted in general surgery department, tertiary hospital. This is a prospective, observational study involving patients with chronic nonhealing ulcers. A total of 105 patients were enrolled in the study, with 35 patients allocated to each treatment group. Participants were evaluated at baseline and followed up weekly for 8 weeks. The primary outcome measures included wound size reduction, time to complete healing, and the incidence of any complications or adverse effects. The secondary outcomes included patient-reported pain levels and quality-of-life assessments.

Results: The demographic data and baseline characteristics were comparable across the three groups. The mean age of participants was 56.2 years, with a slight male predominance (58%). The PRP group demonstrated the highest mean wound size reduction of 75% by the end of the study period, followed by the PDGF gel group with 68%, and the normal saline group with 45%. The differences between the groups were statistically significant (P < 0.05). The average time to complete healing was 5.2 weeks for the PRP group, 6.1 weeks for the PDGF gel group, and 7.8 weeks for the normal saline group. The PRP group showed significantly faster healing compared to the other groups (P < 0.05). Complication rates were low across all groups, with minor adverse effects reported. The PRP group had a 5% incidence of mild local infection, while the PDGF gel group had a 7% incidence. No serious adverse effects were observed. Patient-reported pain levels decreased significantly in all groups, with the most substantial reduction observed in the PRP group. Quality of life improvements were also most pronounced in the PRP group, followed by the PDGF gel group and the normal saline group.

Conclusion: This study concludes that PRP is a highly effective treatment for chronic ulcers, offering faster wound healing and greater wound size reduction compared to PDGF gel and normal saline dressing. PDGF gel also presents a viable alternative with good efficacy. Normal saline, while less effective, remains a baseline treatment option. Further research with larger sample sizes and longer follow-up periods is recommended to confirm these findings and optimize treatment protocols. The superior outcomes observed with PRP highlight its potential as a first-line therapy in the management of chronic ulcers, potentially improving patient outcomes and reducing healthcare costs associated with prolonged wound care.