Efficacy of autologous platelet-rich fibrin compared to normal saline in the management of chronic venous leg ulcers: A randomized controlled trial

ObjectiveTo compare the efficacy of Autologous Platelet-Rich Fibrin (PRF) versus Normal Saline (NS) dressings in healing Chronic Venous Leg Ulcers (CVLUs), focusing on ulcer area reduction and quality of life.MethodsA randomized controlled trial was conducted at a tertiary care center involving 74 patients with chronic venous leg ulcers (CVLUs). Patients were randomized into two groups: Group A (n = 36) received autologous platelet-rich fibrin (PRF) dressings with four-layer compression therapy, while Group B (n = 38) received Normal Saline (NS) dressings with four-layer compression therapy. Ulcer area and Quality of Life were assessed at baseline and at predefined intervals up to 4 weeks, with continued follow-up for 6 months. The quality of life was assessed using the Charing Cross Venous Ulcer Questionnaire (CCVUQ) and the EuroQol-5 Dimension-5 Level (EQ-5D-5L) scores.ResultsBoth groups showed a reduction in ulcer area over time. In the PRF group, mean ulcer area decreased significantly from baseline to 4 weeks (17.46 ± 11.52 cm² to 9.92 ± 8.73 cm²; p = 0.007), whereas the reduction in the saline group was not statistically significant (14.07 ± 14.43 cm² to 11.45 ± 12.02 cm²; p = 0.913). Between-group comparison at 4 weeks was not significant; however, from 4 weeks onward, the PRF group consistently demonstrated smaller mean ulcer areas, with the greatest difference observed at 6 months. CCVUQ and EQ-5D-5L scores improved over time in both groups, with a transient between-group difference favoring PRF at 4 weeks for CCVUQ but no sustained head-to-head superiority in quality-of-life outcomes.ConclusionAutologous PRF, when used as an adjunct to standard compression therapy, is associated with earlier and sustained reduction in ulcer area and improvement in ulcer-related Quality-of-Life in patients with chronic venous leg ulcers. No treatment related adverse events were observed during the study period.