Abstract
The platelet-rich plasma (PRP) treatment has recently been implemented into chronic wound treatment in Japan. PRP is one of regenerative treatments, which utilizes autologous platelet and plasma extracted from a small amount of a patient’s blood and processed via centrifugation. The platelet and plasma fraction is enhanced with ascorbic acid and then mixed with calcified thrombin in a standardized ratio to activate the platelets and form a gel containing many types of growth factors along with fibrin matrix. Chronic wounds such as diabetic foot ulcer and critical limb ischemia fail to progress through the normal, orderly, and timely sequence of repair, then stuck in inflammatory phase because of imbalanced wound bed in which the level of growth factors and tissue inhibiters of matrix are consistently low, on the other hand the levels of matrix metalloproteinases and proinflammatory cytokines are consistently high. PRP treatment restores the balance within the wound bed, causing granulation and vascularization, thus leading the wound toward healing. Unlike highly concentrated PRP that has shown promise in dentistry, oral-maxillofacial surgery, and orthopedic surgery, PRP gel in a physiologically relevant platelet concentration provides rapid and consistent improvement in healing of chronic wounds.
