Regenerative medicine as new tool for wound dressing
(2021) Belgian Surgical Week 2021 — Location: Antwerpen (9.September.2021)
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- Abstract
- We report 2 cases about the use of platelet’s derivative (leucocyte plasma-rich fibrin (L-PRF) and plasma-rich plasma (PRP)) to cure refractory leg ulcer and thromboangiitis obliterans (TAO) ischemic toes ulcers. This innovative regenerative procedure is based on the slow and sustainable growth factors release originating from platelet’s granules and trapped in a fibrin matrix ; it promotes and stimulates tissue regeneration. Moreover, L-PRF matrix serves as insulator between wound and environment, thereby protecting against infection1-2. A 55-years old man suffering from polyvascular comorbidities presented a non-healing wound (right foot) caused by a burn 4 weeks earlier. After appropriate revascularisation surgery, patient still presented a non-healing, fibrinous, aregenerative stump wound (8x3 cm) and VAS about 9/10 despite full dose use of morphine and neuropathic painkillers. Therefore, L-PRF was applicated on the entire wound and left in place for 1 week. The patient was weaned of morphine (VAS 3/10) in the next 48 hours (effect sustainable for 14 days). This procedure was repeated 3 times over 5 weeks : 2,5 months after the first application, wound’s surface had reduced by more than half. A 40-years old man presented with typical TAO’s lesion at the arteriography. L-PRF was used as a dressing for a non-healing wound (left foot). PRP was injected near 3 toes in critical ischemia (right forefoot). Results were similar ; marked by an substantial, fast (72 hours) and sustainable pain relief (VAS 2/10), reduction of painkillers consumption and accelerated wound healing ; results consistent with the first study about this subject3. To our knowledge, it was the first application of PRP in Belgium for this indication. In conclusion, platelet’s derivatives are a new tool in surgeon’s arsenal : they are effective as well for refractory’s wound healing as for fast pain reliever. 1. Pinto N., Ubilla M., Zamora Y. et al. Leucocyte- and platelet-rich fibrin (L-PRF) as a regenerative medicine strategy for the treatment of refractory leg ulcers : a prospective cohort study. Platelets 2018 ; 29 (5) : 468-475. 2. Dohan D., Rasmusson R. et Alberktsson T. Classification of platelet concentrates : from pur platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol 2009 ; 27 (3) : 158-167. 3. Sharma D., Agarwal P., Jain S. et al. Autologous platelet-rich plasma for treatment of ischemic ulcers in buerger’s disease : a pilot study with short-term results. Indian J Vasc Endovasc Surg 2018 ; 5 : 14-20.
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Foguenne, M. (2021, September). Regenerative medicine as new tool for wound dressing. Belgian Surgical Week 2021, Antwerpen. https://hdl.handle.net/2078.5/241252