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      Comparison of Efficacy of Autologous Platelet-Rich Fibrin versus Unna's Paste Dressing in Chronic Venous Leg Ulcers: A Comparative Study

      brief-report
      ,
      Indian Dermatology Online Journal
      Wolters Kluwer - Medknow
      Platelet-rich fibrin, Unna's paste, venous leg ulcer

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          Abstract

          Background:

          Chronic venous leg ulcers are difficult to treat and recurrences are common. Among various modalities of treatment, platelet-rich fibrin (PRF) has shown promising results in ulcer healing by providing necessary growth factors. Unna's paste dressing has also proven to enhance wound healing.

          Aim:

          The aim of this study is to compare the efficacy of autologous PRF versus Unna's paste dressing in chronic venous leg ulcer patients and to compare the mean reduction in ulcer area at the end of 4 weeks.

          Materials and Methods:

          Twenty patients with chronic venous leg ulcers were randomly divided into two groups. Group 1: Patients received PRF dressing which was repeated every week for 4 weeks. Group 2: Patients received Unna's paste dressing once a week for 4 weeks. The ulcer size was assessed with the help of photographs, and ulcer area was measured.

          Results:

          The mean reduction in the area of the ulcer size in the PRF group was 86.03% and in the Unna's paste group was 71.97%, which was not statistically significant with a P value of 0.223.

          Conclusion:

          We conclude that though there was no statistical significance between the groups, PRF showed a significant reduction in ulcer size.

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          Most cited references11

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          Tumor necrosis factor-alpha (TNF-α) is a therapeutic target for impaired cutaneous wound healing.

          Impaired wound healing states lead to substantial morbidity and cost with treatment resulting in an expenditure of billions of dollars per annum in the U.S. alone. Both chronic wounds and impaired acute wounds are characterized by excessive inflammation, enhanced proteolysis, and reduced matrix deposition. These confounding factors are exacerbated in the elderly, in part, as we report here, related to increased local and systemic tumor necrosis factor-alpha (TNF-α) levels. Moreover, we have used a secretory leukocyte protease inhibitor (SLPI) null mouse model of severely impaired wound healing and excessive inflammation, comparable to age-related delayed human healing, to demonstrate that topical application of anti-TNF-α neutralizing antibodies blunts leukocyte recruitment and NFκB activation, alters the balance between M1 and M2 macrophages, and accelerates wound healing. Following antagonism of TNF-α, matrix synthesis is enhanced, associated with suppression of both inflammatory parameters and NFκB binding activity. Our data suggest that inhibiting TNF-α is a critical event in reversing the severely impaired healing response associated with the absence of SLPI, and may be applicable to prophylaxis and/or treatment of impaired wound healing states in humans. © 2011 by the Wound Healing Society.
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            Platelet-rich fibrin application in dentistry: a literature review.

            The development of bioactive surgical additives to regulate the inflammation and increase the speed of healing process is one of the great challenges in clinical research. In this sense, platelet rich fibrin (PRF) appears as a natural and satisfactory alternative with favorable results and low risks. The following review attempts to summarize the relevant literature regarding the technique of using PRF, focusing on its preparation, advantages, and disadvantages of using it in clinical applications. PRF alone or in combination with other biomaterials seems to have several advantages and indications both for medicine and dentistry, due it is a minimally invasive technique with low risks and satisfactory clinical results.
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              • Article: not found

              Platelet-rich fibrin: evolution of a second-generation platelet concentrate.

              Platelet-rich plasma (PRP) is a platelet concentrate that has been used widely to accelerate soft-tissue and hard-tissue healing. The preparation of PRP has been described by several authors. Platelet-rich fibrin (PRF) was first described by Choukroun et al. in France. It has been referred to as a second-generation platelet concentrate, which has been shown to have several advantages over traditionally prepared PRP. Its chief advantages include ease of preparation and lack of biochemical handling of blood, which makes this preparation strictly autologous. This article describes the evolution of this novel platelet concentrate, referred to as PRF.
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                Author and article information

                Journal
                Indian Dermatol Online J
                Indian Dermatol Online J
                IDOJ
                Indian Dermatology Online Journal
                Wolters Kluwer - Medknow (India )
                2229-5178
                2249-5673
                Jan-Feb 2020
                13 January 2020
                : 11
                : 1
                : 58-61
                Affiliations
                [1 ] Department of Dermatology, PSG Hospitals, Coimbatore, Tamil Nadu, India
                Author notes
                Address for correspondence: Dr. Reena Rai, Department of Dermatology, PSG Institute of Medical Sciences and Research , Coimbatore - 641 004, Tamil Nadu, India. E-mail: drreena_rai@ 123456yahoo.co.in
                Article
                IDOJ-11-58
                10.4103/idoj.IDOJ_119_19
                7001417
                32055510
                cfff2697-dc7d-479f-87fc-035ebb580a81
                Copyright: © 2020 Indian Dermatology Online Journal

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : March 2019
                : June 2019
                : June 2019
                Categories
                Brief Report

                Dermatology
                platelet-rich fibrin,unna's paste,venous leg ulcer
                Dermatology
                platelet-rich fibrin, unna's paste, venous leg ulcer

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