Use of Platelet-Rich Plasma (PRP) in the Treatment of Difficult-Healing Wounds: Case Report
Introduction: Platelet-rich plasma (PRP) is a liquid fraction of peripheral blood known for its high platelet concentration and has been used in regenerative medicine due to its stimulation of tissue regeneration. The biologically concentrated, active factors released by platelets, including growth factors, cytokines, and adhesion proteins, influence all stages of the healing process. Despite promising advances, variability in preparation methods presents significant challenges for its clinical application. Objectives: This study aims to evaluate the role of PRP in chronic wound healing and describe an application protocol. Methods: This is a case report conducted at a teaching clinic of a private university center in the Federal District, Brazil. Clinical data were collected from a 67-year-old patient with chronic ankle ulcers through interviews, photo documentation, and informed consent. After consent was obtained, blood samples were collected at all sessions. Thirty ml of whole blood was distributed into heparinized collection tubes and centrifuged at 1800 rpm for five minutes to obtain approximately 8 ml of total plasma. Immediately afterward, simple asepsis was performed at the site to be applied, and the total plasma was added directly to the wound. The plasma concentrate was quantified for its density. The site was covered, and the patient was instructed to keep the dressing with the total plasma for 12 hours and continue with her usual skin care routine. Results: A visible improvement in ulcer healing was observed after the first four PRP treatment sessions, resulting in significant clinical regression. The patient reported sensations of pulling, pain, redness, and tingling during treatment due to the stimulation of healing. Control of inflammation was evident, with decreased hyperemia and swelling, thinning, and renewal of the keratinization process of the wound edges, culminating in a marked decrease in tissue damage. The application protocol was rigorously applied in all sessions to establish a baseline for describing a standard protocol. Conclusion: The results highlight the potential of PRP as an effective therapy for promoting ulcer healing. Patients with chronic conditions, difficult-to-control comorbidities, ineffective pharmacotherapy, and other unfavorable environmental conditions indicate this type of treatment as a preferred option, as the protocol is simple and comfortable, does not require exorbitant financial expenditures on traditional dressings, and does not affect the patient’s overall health status. Continued research in this area is essential to optimize the clinical use of PRP and improve healing outcomes in patients with this complex condition.
