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What Is PRP Therapy?

PRP therapy involves using a concentrated solution of the patient’s own platelets derived from their blood. Platelets are rich in growth factors like platelet-derived growth factors (PDGF), transforming growth factor-β, vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF), which are critical for tissue repair and regeneration. The PRP is injected or applied to the wound area to stimulate healing responses at a cellular level.

Mechanism of Action in Non-Healing Ulcers

Growth Factor Release and Tissue Regeneration

• PRP delivers a high concentration of growth factors to the ulcer site, promoting fibroblast proliferation, collagen synthesis, and angiogenesis (formation of new blood vessels).

• This accelerated cellular activity leads to the formation of granulation tissue, filling the ulcer from the base upwards and facilitating quicker closure.

• PRP also modulates inflammation, reducing excess chronic inflammation that often impedes healing in non-healing ulcers.

Enhanced Wound Healing Phases

1. Hemostasis and Inflammation: PRP promotes platelet aggregation and releases factors that attract stem cells to the injury.

2. Proliferation: Growth factors induce fibroblast activation, stimulating new extracellular matrix and capillary formation.

3. Maturation: PRP influences remodeling, improving tissue strength and durability.

Clinical Benefits of PRP in Chronic Ulcers

Efficacy in Diverse Ulcer Types

Studies have reported substantial improvements in various non-healing ulcers, including diabetic ulcers, venous ulcers, and trophic ulcers due to leprosy. For instance, a notable study showed over 90% reduction in ulcer size in many patients after several weekly PRP treatments, with some achieving complete healing within weeks. PRP minimizes risks associated with immune reactions since the plasma is autologous (from the patient’s own blood).

Safety Profile and Treatment Convenience

• PRP is minimally invasive and generally well-tolerated. Some patients may experience minor discomfort at the injection site.

• Since it uses the patient’s own blood components, the risk of infection or allergic reactions is low.

• Treatment is often outpatient and can be repeated weekly depending on wound response.

Practical Considerations for PRP Therapy

Treatment Protocol

• Blood is drawn from the patient and centrifuged to concentrate platelets.

• Approximately 1.5–2 ml of PRP is injected at the ulcer margins after cleansing the wound.

• Typical regimens involve weekly sessions for 4 to 6 weeks.

• Assessment includes measuring ulcer area and volume reduction using standardized scales.

Limitations and Future Directions

• Larger controlled trials are needed to establish standardized treatment protocols and optimize dosages.

• PRP therapy complements but does not replace core wound care practices like infection control, offloading, and vascular assessment.

• Emerging alternatives like platelet-rich fibrin (PRF) have been explored but PRP shows higher growth factor release.