The contribution of platelet-rich plasma in the management of leg ulcers

Objectives: The objectives of the study are to evaluate the efficacy and safety of perilesional platelet-rich plasma (PRP) injections combined with PRP-impregnated dressings in accelerating healing and reducing pain in chronic leg ulcers compared with standard care. Materials and Methods: This single-center, double-blind, randomized controlled trial enrolled 60 adults (17–68 years) with non-healing leg ulcers of 1–7 months’ duration. Participants were randomized (1:1) into two groups: (1) PRP group ( n = 30), receiving monthly perilesional PRP injections (5 mL) for 3 months plus twice-weekly PRP-soaked dressings until closure, and (2) Control group ( n = 30), receiving twice-weekly standard sterile dressings. The primary outcomes were the healing rate (complete epithelialization at 12 months) and the mean healing time. The secondary outcome was pain reduction, assessed with the Visual Analog Scale (VAS). Data were analyzed using the Chi-square test, t -test, or Mann–Whitney U test, with P < 0.05 considered significant. Results: All 60 patients completed the study. Healing was achieved in 79% of the PRP group compared to 52% of the controls ( P = 0.02). Mean healing time was significantly shorter with PRP (7.0 ± 1.2 months) than with standard dressings (12.9 ± 1.5 months; P < 0.001). Pain scores decreased more substantially in the PRP group (Δ – 6.0, final VAS 2.0 ± 0.6) compared with controls (Δ – 4.0, final VAS 4.0 ± 0.9; P < 0.001). No serious adverse events occurred; minor transient injection-site discomfort was reported in four patients. Conclusion: Adjunctive PRP therapy significantly accelerates ulcer closure and enhances pain relief compared with conventional dressings, achieving a 79% healing rate within 7 months and a mean VAS reduction of 6 points. PRP represents a safe and cost-efficient alternative for chronic leg ulcer management. Larger multicenter trials are warranted to validate these findings and optimize treatment protocols.