The treatment of refractory wounds with apheresis platelet-rich plasma

Objective To explore the model of treatment of refractory wounds by apheresis platelet-rich plasma (PRP), and evaluate its efficacy and safety. Methods PRP treatment was carried out for 34 patients with refractory wounds who were hospitalized in our hospital from June 2020 to December 2023. The patient′s autologous PRP was collected by the blood composition separator. PRP point-like injection and/or direct application along the edge of the wound, or platelet gel (PG) to cover the wound and fill the sinus were used to treat different types of wounds. The frequency of treatment was once to twice a week, with each course of treatment consisting of 4 to 5 sessions. The efficacy was observed and recorded, and the safety was evaluated. Results Before PRP collection, the basal platelet, white blood cell and red blood cell counts were (321.85±114.64) ×109/L, (9.52±3.21) ×109/L and (4.34±0.62) ×1012/L, respectively. The counts of platelets, white blood cells and red blood cells in PRP products were (1 438.53±376.89)×109/L, (1.38±1.03)×109/L and (0.03±0.01)×1012/L, respectively. The platelet concentration of PRP products increased by 4.47 times on average, and the sampled bacterial culture was negative. Out of 34 patients treated with PRP, 33 showed improvement in symptoms, while 1 did not respond well due to long-term bedridden and poor compliance. Four patients had mild adverse reactions during PRP collection or treatment, but all were able to complete PRP collection or treatment after standardized treatment. Conclusion Apheresis PRP products have the advantages of stable quality, safety, reliability and traceability, and can effectively promote the healing of a variety of refractory wounds. Its treatment process is safe and effective, and is worthy of popularization and application.