Comparative Study between Negative Pressure Wound Therapy and Platelet Rich Plasma in Neovascularization of Chronic Wound Healing

Document Type : Research article

Authors

1 The Department of Plastic Surgery, Ahmed Maher Teaching Hospital, Cairo ; Egypt

2 The Departments of Plastic Surgery, Faculty of Medicine, Mansoura University

3 The Departments of Pathology Faculty of Medicine, Mansoura University

4 The Departments of Plastic Surgery** , Faculty of Medicine, Mansoura University

Abstract

Background: Chronic wound healing is a significant health
problem. Increased angiogenesis and blood flow had been
shown to facilitate the healing of chronic wounds. Negative
pressure wound therapy and platelet rich plasma may be used
for treatment of various chronic wounds, especially when
standard conventional therapy is not good enough or for
preparation for definitive closure.
Objectives: To compare the efficacy of negative pressure
wound therapy and platelet rich plasma in neovascularization
of chronic wound healing.
Patient and Method: Twenty patients with chronic wound
were divided into two groups. Wound tissue biopsies were
collected from the centeraland peripheral of the wound before
starting our procedure and after one, two and three weeks in
both groups. Evaluation of the wound clinically and Immunohistochemically
for vascular endothelial growth factor
(VEGF) and CD31 (cluster of differentiation) were done.
Results: PRP and NPWT were effective in neovasculization
and stimulation of healing process. The expression of VEGF
in PRP patients after the third week was mild 10%, moderate
20%, strong 70% and was mild 10%, moderate 20%, strong
70% in peripheral and central tissue biopsy respectively. While
in NPWT patient was mild 20%, moderate 30%, strong 50%
in both peripheral and central tissue biopsy. The average of
blood vessels formation in CD-31 was 9.95±3.64 after 3 week
in peripheral tissue biopsy and was 8.58±3.51 in central tissue
biopsy in PRP patients. While in NPWT patients was 8.35±3.25
in peripheraltissue biopsy and was 8.38±3.12 in central tissue
biopsy.
Conclusion: PRP and NPWT are effective in treatment
chronic wounds. PRP is more simple, less costly, shorter time
for the method, less painful, no hospital stay and less transmission
of infections.

Keywords

Main Subjects

References

Hurd T., Chadwick P., Cote J., Cockwill J., Mole R. and
Smith J.M.: Impact of gauze-based NPWT on the patient
and nursing experience in the treatment of challenging
wounds. International Wound Journal, 7 (6): 448-455,
2010.
2- Gupta S., Gabriel A., LantisJ. and Téot L.: Clinical recommendations
and practical guide for negative pressure
wound therapy with instillation. Int. Wound J., 13: 159-
174, 2016.
3- Masiero F.S. and Thyssen P.J.: Evaluation of conventional
therapeutic methods versus maggot therapy in the evolution
of healing of tegumental injuries in Wistar rats with and
without diabetes mellitus. Parasitol Res., 115 (6): 2403-
2407, 2016.
4- Guo S.C., Tao S.C., Yin W.J., Qi X., Yuan T. and Zhang
C.Q.: Exosomes derived from platelet-rich plasma promote
the re-epithelialization of chronic cutaneous wounds via
activation of YAP in a diabetic rat model, 7 (1): 81-96,
2017.
5- Ann H., Bart Landuyt, Martin S. Highley, Han Wildiers
and Allan T. Van: Vascular Endothelial Growth Factor
and Angiogenesis. Pharmacological Reviews, Vol. 56,
(4): 549-580, 2004.
6- Johnson K. and Wilgus T.: Vascular Endothelial Growth
Factor and Angiogenesis in the Regulation of Cutaneous
Wound Repair. Advances in Wound Care, 3 (10): 647-
661, 2014.
7- Argenta L.C. and Morykwas M.J.: Vacuum-assisted closure:
A new method for wound control and treatment:
Clinical experience. Ann. Plast. Surg., 38 (6): 563-576;
discussion 577, 1997.
8- Kairinos N., McKune A., Solomons M., Hudson D.A. and
Kahn D.: The flaws of laser Doppler in negative-pressure
wound therapy research. Wound Repair Regen, 22 (3):
424-429, 2014.
9- Pietrzark W. and Eppley B.: Platelet rich plasma: Biology
and new technology. J. Cranio Facial Surg., 16 (6): 1043-
1054, 2005.
10- Andia I. and Abate M.: Platelet-rich plasma: Underlying
biology and clinical correlates. Regen Med., 8 (5): 645-
658, 2013.
11- Nurden A.: Platelets, inflammation and tissue regeneration.
Thromb Haemost, 105 (Supple 1): S13-33, 2011.
12- Kececi Y., Ozsu S. and Bilgir O.: A cost- effective method
for obtaining standard platelet-rich plasma. Wound, 26
(8): 232-238, 2014.
Egypt, J. Plast. Reconstr. Surg., January 2018 43
13- Gasbarro R: Negative pressure wound therapy: A clinical
review. wounds: Compendium of clinical research and
practice, 19 (12): 2-7, 2007.
14- Blanton M.W., Hadad I., Johnstone B.H., Mund J.A.,
Rogers P.I., Eppley B.L. and March K.L.: Adipose stromal
cells and platelet-rich plasma therapies synergistically
increase revascularization during wound healing. Plast.
Reconstr. Surg., 123 (2 Supple): 56S-64S, 2009.
15- Han G. and Ceilley R.: Chronic Wound Healing: A Review
of Current Management and Treatments. Adv. Ther., 1-
12, 2017.
16- Erba P., Ogawa R., Ackermann M., Adini A., Miele L.F.,
Dastouri P., Helm D., Mentzer S.J., D'Amato R.J., Murphy
G.F., Konerding M.A. and Orgill D.P.: Angiogenesis in
wounds treated by microdeformational wound therapy.
Ann. Surg., 253 (2): 402-409, 2011.
17- Dini V., Miteva M., Romanelli Bertone M. and Romanelli
M.: Immunohistochemical evaluation of venous leg ulcers
before and after negative pressure wound therapy. Wounds,
23 (9): 257-266, 2011.
18- Wilcox J.R., Carter M.J. and Covington S.: Frequency of
debridement and time to heal: A retrospective cohort study
of 312-744 wounds. JAMA Dermatol., 149 (9): 1050-
1058, 2013.
19- Armstrong D.G. and Lavery L.A.: Diabetic Foot Study
Consortium. Negative pressure wound therapy after partial
diabetic foot amputation: A multicentrerandomized controlled
trial. Lancet, 366 (9498): 1704-1710, 2005.
20- Yao M., Fabbi M., Hayashi H., Park N., Attala K., Gu G.,
French M.A. and Driver V.R.: A retrospective cohort study
evaluating efficacy in high-risk patients with chronic
lower extremity ulcers treated with negative pressure
wound therapy. Int. Wound J., 11 (5): 483-488, 2014.
21- Lalezari S., Lee C.J., Borovikova A.A., Banyard D.A.,
Paydar K.Z., Wirth G.A. and Widgerow A.D.: Deconstructing
negative pressure wound therapy. Int. Wound
J., 2-3, 2016.
22- Frykberg R.G., Driver V.R., Carman D., Lucero B., Borris-
Hale C., Fylling C.P., Rappl L.M. and Clausen P.A.:
Chronic wounds treated with a physiologically relevant
concentration of platelet-rich plasma gel: A prospective
case series. Ostomy Wound Manage, 56 (6): 36-44, 2010.
23- Kakudo N., Kushida S., Ogura N., Hara T. and Suzuki
K.: The use of autologous platelet rich plasma in the
treatment of intractable skin ulcer. Open J. Reg. Med., 1
(3): 29-32, 2012.
24- Suthar M., Gupta S., Bukhari S. and Ponemone V.: Treatment
of chronic non-healing ulcers using autologous
platelet rich plasma: A case series. J. Biomed Sci.,
24(1):16-26, 2017.
25- Danielsen P., Jorgensen B., Karlsmark T., Jorgensen L.N.
and Agren M.S: Effect of Topical Autologous Platelet-
Rich Fibrin versus No Intervention on Epithelialization
of Donor Sites and Meshed Split-Thickness Skin Auto
grafts: A Randomized Clinical Trial. Plastic and Reconstructive
Surgery, 122 (5): 1431-1440, 2008.
26- Steenvoorde P., van Doorn L.P., Naves C. and Oskam J.:
Use of autologous platelet rich fibrin on hard-to-heal
wounds. J. Wound Care, 17: 60-63, 2008
The Egyptian Journal of Plastic and Reconstructive Surgery
Volume 42, Issue 1
January 2018
Pages 35-43

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