Application of autologous platelet-rich gel to non healing vascular ulcers

Aim. The aim of this study was the evaluation of the safety and efficacy of autologous platelet-rich gel for the treatment of non-healing vascular ulcers, not responsive to the conventional wound care techniques. Methods. Sixteen patients with vascular chronic wounds were selected, with peripheral arterial disease, vasculitis and post-thrombotic chronic venous insufficiency. Every patient had non-healing wounds, not responsive to conventional treatment carried on for at least one month. The platelet gel obtained either from whole-blood derived platelet concentrates (PC) or from plateletapheresis concentrates (PAC) was applied and the medication was completed with a soft dressing. Pictures of the lesions were performed at the beginning of the treatment and every time the platelet gel was applied on the wound. The end-points were the healing or the reduction of the lesion area, the improvement of the ulcer features and the reduction of pain. Results. Five patients healed up, in eight patients we registered an early improvement with reduction of the lesion area and growth of the bottom of the ulcer with granulation tissue, without the complete healing. In the great majority of the patients we obtained a decisive reduction of pain. Only in three patients we had the worsening of the ulcer with a consequent amputation. Conclusion. This treatment is effective in the majority of cases, without side effects. The easy application, the almost complete absence of side effects and the low cost of platelet gel make this approach very interesting to treat chronic non-healing ulcers.