Efficacy of Intralesional Platelet-Rich Plasma in Diabetic Foot Ulcer

Background: Diabetic foot ulcer (DFU) is well managed by infection control, euglycemic state, and debridement of the ulcer followed by appropriate dressing and off-loading of the foot. Studies show that approximately 90% of DFUs that are properly off-loaded heal in nearly 6 weeks. Platelet-rich plasma (PRP) serves as a growth factor agonist and has mitogenic and chemotactic properties that help in DFU healing. We sought to evaluate the efficacy of local application of PRP with respect to healing rate and ulcer area reduction in treating DFUs. Methods: Sixty noninfected patients with DFUs (plantar surface area, <= 20 cm(2); Meggitt-Wagner grades 1 and 2) were randomized to receive normal saline dressing (control group [CG]) or PRP dressing (study group [SG]) along with total-contact casting for 6 weeks or until complete ulcer healing, whichever was earlier. Healing rate and change in ulcer area were evaluated weekly. Results: Mean +/- SD ulcer area at baseline was 4.96 +/- 2.89 cm(2) (CG) and 5.22 +/- 3.82 cm(2) (SG) (P = .77), decreasing to 1.15 +/- 1.35 cm(2) (CG) and 0.96 +/- 1.53 cm(2) (SG) (P = .432) at 6 weeks. Mean +/- SD percentage reduction in healing area at 6 weeks was 81.72% +/- 17.2% (CG) and 85.98% +/- 13.42% (SG) (P = .29). Mean +/- SD healing rate at 6 weeks was 0.64 +/- 0.36 cm(2) (CG) and 0.71 +/- 0.46 cm(2) (SG) (P = .734). Conclusions: The PRP dressing is no more efficacious than normal saline dressing in the management of DFU in conjunction with total-contact casting.