European Journal of Molecular & Clinical Medicine

Abstract

Aim
To observe the efficacy of autologous PRP and phenytoin sodium powder in the healing of non healing ulcer.
Material & methods
This prospective randomized controlled study included Sample size of 90 patients ( at least 30 in each group). Patients of all age groups with non healing ulcers of more than 3 months duration, irrespective of its aetiology. Debridement of dead necrotic tissue which was done every week after opening the dressing before measuring ulcer size.Every ulcer was tested for culture & sensitivity & treated with specific antibiotics before specific interventions were applied.  The patients were randomly allocated to one of the three groups as per their presentation first patient in A, second in B, third in C, fourth again in A, fifth in B & so on.
Results:
Diabetic ulcers (50%) were the commonest, followed by venous (25%), traumatic & pressure sores in the same order.The patients subjected to Group A, that were treated with autologous PRP gel, showed a statistically significant mean reduction in volume of the ulcer (17.86±15.63 cm³) by the end of 3 weeks leading to partial or total granulation in 22 patients & complete re-epithelization in 6 out of 30 cases. The patients subjected to Group B, that were treated with Phenytoin sodium suspension, showed a reduction in the mean ulcer volume (7.32±5.32 cm³) by the end of 3 weeks of treatment which was not statistically significant, leading to partial or total granulation in 70% patients & complete re-epithelization in 13 % out of 30 cases. Almost no healing was seen in 16% of the total cases.The patients subjected to Group C, that were treated with conventional normal saline dressings, showed a reduction in the mean ulcer volume (6.21±6.21 cm³) by the end of 3 weeks of treatment which was not statistically significant when compared to other groups, leading to partial or total granulation in 70% patients & complete re-epithelization in none of the cases.The results with PRP were better than with Phenytoin group.Total healing rate of 20% was seen with PRP group as compared to  zero patients with complete re-epithelization in conventional normal saline dressing group. The results with PRP as compared to Normal saline group. Total healing rate of 13.3% in Phenytoin group as compared to zero patients with complete re-epithelization in conventional normal saline dressing group. The results were better with phenytoin as compared to normal saline group.Autologous PRP gel showed significant reduction in mean ulcer volume of all aetiology when compared to phenytoin sodium suspension. No side effects were documented in any of the three groups.
Conclusion:
Autologous PRP therapy is a safe, efficacious& cost effective method in the healing of chronic non-healing ulcers. There was no risk of adverse effects. Moreover, even phenytoin sodium powder suspension is cost-effective, more efficacious as compared to conventional normal saline dressings in treating chronic non-healing ulcers.