Adjunctive Autologous Platelet-Rich Plasma Activated with Autologous Thrombin Serum for a Refractory Below-Knee Amputation Stump Wound: A Case Report.

Abstract

Background and Clinical Significance: Refractory below-knee amputation (BKA) stump wounds can delay prosthetic rehabilitation. This report describes wound healing during multimodal care that included autologous platelet-rich plasma (PRP) activated with autologous thrombin serum (ATS); Case Presentation: A 33-year-old man with Charcot-Marie-Tooth disease and a persistent right BKA stump wound after surgical revisions underwent three PRP-ATS applications on 16 and 23 February and 8 March 2026. Collagen dressings were applied on 2 and 15 March, and compression was continued thereafter. The estimated wound volume decreased from 14.18 cm³ at baseline to 0.48 cm³ at week 3 (approximately 97%); advanced epithelialization was observed at week 4. Complete closure was documented on 16 April 2026, approximately eight weeks after treatment began. No treatment-related adverse events were reported. After closure, the patient was referred for prosthetic rehabilitation assessment; fitting and functional use were not documented; Conclusions: Healing was temporally associated with PRP-ATS as part of a multimodal treatment course. This single case supports the feasibility of the approach but cannot establish the independent efficacy of PRP-ATS.