Use of PRP for the Healing of Grade III Ulcers

• Introduction

Platelet-rich plasma (PRP) is an autologous blood derivative obtained by centrifuging the patient's own blood. It contains a high concentration of growth factors that promote tissue regeneration and cell proliferation. Its use in the treatment of chronic ulcers has shown good results, especially in wounds that do not respond to conventional treatments.

• Required Materials

Sterile 5 ml and 10 ml syringes

Needles or butterfly needle and 20G vacutainer for extraction, and 30G (4 mm or 13 mm) for infiltration

Tube with anticoagulant (3.8% sodium citrate), closed system technique

Clinical centrifuge with fixed-angle or swinging-bucket rotor

Gloves, mask, gown, and sterile working surface

Sterile dressings, saline solution, and antiseptics

• Blood Extraction

Draw between 10 and 20 ml of venous blood from the patient, depending on the extent of the ulcer. Use tubes with anticoagulant to prevent premature coagulation.

Apply a closed system technique to avoid handling and contamination of the sample.

• Centrifugation

Use a single centrifugation cycle to obtain high-quality PRP: 3500 rpm for 10 minutes.

Once the process is complete, prepare the PRP in the selected 5 ml or 10 ml syringes.

• PRP Application

→ Before application:

Clean the wound with saline solution and antiseptic.

Perform debridement if there is necrotic or fibrinous tissue.

→ Application methods:

Intradermal or subdermal perilesional infiltration using a fine needle (30G 4 mm or 30G 13 mm).

Direct application of PRP onto the wound bed.

Apply a topical layer.

Cover with a sterile dressing or gauze soaked in the same PRP.

• Monitoring and Follow-Up

Evaluate the wound weekly or biweekly.

Repeat treatment every 1-2 weeks depending on progress.

Take photographs and document each visit to assess clinical response.

• Contraindications and Precautions

Severe thrombocytopenia (< 100,000 platelets/μL)

Active systemic infection

Severe hematological disorders

Do not administer in case of allergy to the anticoagulants used

Active local infection

• Conclusions

PRP represents an innovative and safe therapeutic option in the management of chronic ulcers, with good clinical outcomes and minimal side effects when performed using the appropriate technique.

Inclusion criteria

• Patients with Grade III ulcers.
• Patients with ulcers older than two weeks.
• Patients with an optimal platelet count according to prior laboratory tests.

Exclusion criteria

• Patients with a palliative profile.
• Patients with a limited life expectancy.
• Patients with a platelet count below 10 × 10⁹/L