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The Clinical Relevance of Treating Chronic Wounds with an Enhanced Near-Physiological Concentration of Platelet-Rich Plasma Gel

de Leon, Jean M. MD; Driver, Vickie R. DPM, MS, FACFAS; Fylling, Carelyn P. MSN, RN, CWS, CLNC; Carter, Marissa J. PhD, MA; Anderson, Carol MSN, RN, CWCN; Wilson, Janice BSN, RN, CWOCN; Dougherty, Rita Michelle BSN, RN, CWCN; Fuston, Denise LPN, WCC; Trigilia, Donna MSN, BC, APRN, CWCN; Valenski, Vicky MSPT, CWS; Rappl, Laurie M. DPT, PT, CWS

Advances in Skin & Wound Care: August 2011 - Volume 24 - Issue 8 - pp 357-368
doi: 10.1097/01.ASW.0000403249.85131.6f
Features: Original Investigation

OBJECTIVE: This study investigated clinical outcomes in chronic nonhealing wounds following the short-term use of an enhanced, near-physiological concentration of platelet-rich plasma (PRP) gel (AutoloGel System, Cytomedix, Inc, Gaithersburg, Maryland).

DESIGN: Study design was a large, observational case series using a multicenter registry database (all wounds included), which compared different populations within the database.

SETTING: Thirty-nine centers contributed to the registry, including long-term acute-care centers, outpatient clinics, a durable medical equipment company, a home health agency, and a long-term-care center.

PATIENTS: The target population included 285 chronic wounds (patient n = 200). Wound etiologies included diabetic, pressure, or venous ulcer; dehisced, surgical, or traumatic wound; and wounds of other etiologies.

INTERVENTION: Therapeutic, PRP gel is produced from patient blood utilizing autologous platelets and plasma that contribute growth factors, cytokines, and chemokines, in a fibrin matrix.

MAIN MEASURES: Area and volume of the wound and the linear total of undermining and sinus tracts/tunneling were calculated. Clinical relevance was determined by analyzing outcomes in wounds that responded to treatment.

MAIN RESULTS: A positive response occurred in 96.5% of wounds within 2.2 weeks with 2.8 treatments. In 86.3% of wounds, 47.5% area reduction occurred, and 90.5% of wounds had a 63.6% volume reduction. In 89.4% undermined and 85.7% of sinus tracts/tunneling wounds, 71.9% and 49.3% reductions in linear total were observed, respectively.

CONCLUSION: In chronic wounds recalcitrant to other treatments, utilization of PRP gel can restart the healing process. Rapid treatment response was observed in 275 of 285 wounds, and the magnitude of response was consistently high, with statistically significant outcomes reported for various subgroups.

This study investigated the clinical outcomes in chronic nonhealing wounds following the short-term use of an enhanced, near-physiological concentration of platelet-rich plasma gel.

Jean M. de Leon, MD, is medical director, Baylor Specialty Hospital, Dallas, Texas. Vickie R. Driver, DPM, MS, FACFAS, is associate professor of surgery; director, Clinical Research Limb Preservation and Wound Healing; and director, Research Fellowship and International Scholars Program, Boston University Medical Campus and Boston University School of Medicine, Massachusetts. Carelyn P. Fylling, MSN, RN, CWS, CLNC, is vice president of Professional Services, Cytomedix, Inc, Gaithersburg, Maryland. Marissa J. Carter, PhD, MA, is president of Strategic Solutions, Inc, Cody, Wyoming. Carol Anderson, MSN, RN, CWCN, is CWCN Consultant, Cytomedix, Inc, Gaithersburg, Maryland. Janice Wilson, BSN, RN, CWOCN, is Director of Wound Therapy, Asheville Specialty Hospital, Asheville, North Carolina. Rita Michelle Dougherty, BSN, RN, CWCN, is Director of Inpatient Wound Care, LTAC, West Monroe, Louisiana. Denise Fuston, LPN, WCC, is a wound care nurse, Tucson, Arizona. Donna Trigilia, MSN, BC, APRN, CWCN, is coordinator of the Wound Care Program, and Vicky Valenski, MSPT, CWS, is a level II physical therapist, Gaylord Specialty Healthcare, Wallingford, Connecticut. Laurie M. Rappl, DPT, PT, CWS, is clinical liaison, Cytomedix, Inc, Gaithersburg, Maryland.

Submitted March 2, 2011; accepted in revised form May 4, 2011.

© 2011 Lippincott Williams & Wilkins, Inc.