Efficacy of autologous platelet-rich fibrin in chronic cutaneous ulcer: a randomized controlled trial

Background: Platelet derived growth factors have been used as topical adjuvant therapy in chronic cutaneous ulcer. However the clinical evidence for effectiveness is limited. Therefore, this study was performed to evaluate the efficacy of topical platelet rich fibrin (PRF) dressing in the treatment of chronic cutaneous ulcer. Aims: To evaluate the efficacy of topical platelet rich fibrin (PRF) dressing in the treatment of chronic cutaneous ulcer in comparison to conventional dressing. Methods: An assessor-blinded, parallel group, randomized controlled trial was undertaken in 50 patients with chronic cutaneous ulcers of more than 6 weeks duration attending the outpatients, department of dermatology, BPKIHS, Nepal and followed up for 8 weeks. All patients were 18 years or older with ulcers size >0.5 cm2 to ≤50cm2, baseline hemoglobin >9 gram/dl, platelets >1,00,000 cells/cm3, Serum protein concentrations above 6 gram/dl, fasting blood glucose <140 mg/dl and postprandial <200 mg/dl. Results: The PRF and the conventional groups were equivalent for ulcer size, ulcer duration and other characteristics. Median 100% healing was seen earlier in PRF group (4th Week) in comparison to conventional group (7th week). The Kaplan Meir median time to complete healing in the PRF group was 3.5 weeks compared to 4.19weeks in the conventional group. Limitations: single center study. Conclusion: In comparison to conventional dressing, platelet rich fibrin dressings had shown faster healing of chronic cutaneous ulcer. PRF dressing is a safe nonsurgical adjuvant therapy for chronic cutaneous ulcers.