Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지
DOI QR코드

DOI QR Code

Intralesional Injection of Autologous Platelet-Rich Plasma as an Effective Regeneration Therapy: A Case Report of Chronic Wagner Grade 2 Diabetic Foot Ulcer

증례 보고: 병변 내 자가 혈소판풍부혈장 주사로 효과적으로 재생된 만성화된 Wagner Grade 2 당뇨발 궤양 1예

  • Received : 2022.08.03
  • Accepted : 2022.09.07
  • Published : 2022.12.15
Download PDF
⟨ Previous Next ⟩

Abstract

The author experienced a case of autologous platelet-rich plasma (PRP) affecting the recovery of a chronic neuropathic diabetic foot ulcer combined with infection. A 65-year-aged male with uncontrolled diabetes presented with a Wagner grade 2 diabetic foot ulcer on his left forefoot of more than 2 weeks duration. Osteomyelitis, gangrene, and ischemia requiring acute intervention were absent. Although infection was controlled to a moderate degree, wound healing was unsatisfactory following surgical debridement and simple dressing. Therefore, intralesional autologous PRP injection was performed 5 times as an adjuvant regeneration therapy, and the recalcitrant ulcer healed in 3 months. Intralesional PRP injections are worthwhile as they promote wound regeneration, are evidence-based, safe, and can be easily performed in ambulatory care facilities.

Keywords

Acknowledgement

The author thanks Young-Jin Lee. M.D. for his endocrinological and neurological support.

References

  1. Andrews KL, Houdek MT, Kiemele LJ.Wound management of chronic diabetic foot ulcers: from the basics to regenerative medicine. Prosthet Orthot Int. 2015;39:29-39. doi: 10.1177/0309364614534296.
  2. Milne TE, Schoen DE, Bower VM, Burrows SA, Westphal C, Gurr JM. Healing times of diabetic foot ulcers: investigating the influence of infection and peripheral arterial disease. J Diabet Foot Complicat. 2013;5:29-38.
  3. Schaper NC, van Netten JJ, Apelqvist J, Bus SA, Hinchliffe RJ, Lipsky BA. Practical guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update). Diabetes Metab Res Rev. 2020;36 Suppl 1:e3266. doi: 10.1002/dmrr.3266.
  4. Scimeca CL, Bharara M, Fisher TK, Kimbriel H, Armstrong DG. Novel use of platelet-rich plasma to augment curative diabetic foot surgery. J Diabetes Sci Technol. 2010;4:1121-6. doi: 10.1177/193229681000400510.
  5. Everett E, Mathioudakis N. Update on management of diabetic foot ulcers. Ann N Y Acad Sci. 2018;1411:153-65. doi: 10.1111/nyas.13569.
  6. Lipsky BA, Senneville E, Abbas ZG, Aragon-Sanchez J, Diggle M, Embil JM, et al.; International Working Group on the Diabetic Foot (IWGDF).Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update). Diabetes Metab Res Rev. 2020;36 Suppl 1:e3280. doi: 10.1002/dmrr.3280.
  7. Kim MH, Byeon HS. Review for good platelet-rich plasma procedure in cosmetic dermatology and surgery. J Cosmet Med. 2019;3:1-13. doi: 10.25056/JCM.2019.3.1.1.
  8. Zimny S, Schatz H, Pfohl M. Determinants and estimation of healing times in diabetic foot ulcers. J Diabetes Complications. 2002;16:327-32. doi: 10.1016/s1056-8727(01)00217-3.
  9. Monami M, Ragghianti B, Nreu B, Lorenzoni V, Pozzan M, Silverii A, et al. Major amputation in non-healing ulcers: outcomes and economic issues. Data from a cohort of patients with diabetic foot ulcers. Int J Low Extrem Wounds. Published online April 28, 2022; doi: 10.1177/15347346221097283.
  10. Won SH, Min TH, Chun DI, Bae SY; The Academic Committee of Korean Foot and Ankle Society. Current trends in the treatment of diabetic foot: analysis of the Korean Foot and Ankle Society (KFAS) member survey. J Korean Foot Ankle Soc. 2022;26:30-9. doi: 10.14193/jkfas.2022.26.1.30.