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Use of platelet-rich plasma and modified nanofat grafting in infected ulcers: Technical refinements to improve regenerative and antimicrobial potential
- Source :
- Archives of Plastic Surgery, Vol 47, Iss 03, Pp 217-222 (2020)
- Publication Year :
- 2020
- Publisher :
- Thieme Medical Publishers, Inc., 2020.
-
Abstract
- Background Surgical reconstruction of chronic wounds is often infeasible due to infection, comorbidities, or poor viability of local tissues. The aim of this study was to describe the authors’ technique for improving the regenerative and antimicrobial potential of a combination of modified nanofat and platelet-rich plasma (PRP) in nonhealing infected wounds. Methods Fourteen patients met the inclusion criteria. Fat tissue was harvested from the lower abdomen following infiltration of a solution of 1,000 mL of NaCl solution, 225 mg of ropivacaine, and 1 mg of epinephrine. Aspiration was performed using a 3-mm cannula with 1-mm holes. The obtained solution was decanted and mechanically emulsified, but was not filtered. Non-activated leukocyte-rich PRP (naLR-PRP) was added to the solution before injection. Patients underwent three sessions of injection of 8-mL naLR-PRP performed at 2-week intervals. Results Thirteen of 14 patients completed the follow-up. Complete healing was achieved in seven patients (53.8%). Four patients (30.8%) showed improvement, with a mean ulcer width reduction of 57.5%±13.8%. Clinical improvements in perilesional skin quality were reported in all patients, with reduced erythema, increased thickness, and increased pliability. An overall wound depth reduction of 76.6%±40.8% was found. Pain was fully alleviated in all patients who underwent re-epithelization. A mean pain reduction of 42%±33.3% (as indicated by visual analog scale score) was found in non-re-epithelized patients at a 3-month follow-up. Conclusions The discussed technique facilitated improvement of both the regenerative and the antimicrobial potential of fat grafting. It proved effective in surgically-untreatable infected chronic wounds unresponsive to conventional therapies.
- Subjects :
- platelet-rich plasma
anti-infective agents
tissue grafts
ulcer
wounds
Surgery
RD1-811
Subjects
Details
- Language :
- English
- ISSN :
- 22346163 and 22346171
- Volume :
- 47
- Issue :
- 03
- Database :
- Directory of Open Access Journals
- Journal :
- Archives of Plastic Surgery
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.ba0f2516082f46fc9b47a27e474d3749
- Document Type :
- article
- Full Text :
- https://doi.org/10.5999/aps.2019.01571