Wound Healing in Diabetic Foot Ulcer Patients Using Combined Use of Platelet Rich Fibrin and Hyaluronic Acid, Platelet Rich Fibrin and Placebo: An Open Label, Randomized Controlled Trial
Background: Autologous platelet-rich fibrin (A-PRF) is an adjunctive method for diabetic foot ulcer (DFU) in addition to glycaemic control and debridement. This study aimed to evaluate the role of A-PRF + hyaluronic acid (HA), A-PRF and sodium chloride 0.9% (control) in DFU wound healing. Nowaday, t...
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Interna Publishing
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doaj-e007c2a509e44fc0b3efcf753eb358962021-10-06T07:20:36ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322021-07-01533445Wound Healing in Diabetic Foot Ulcer Patients Using Combined Use of Platelet Rich Fibrin and Hyaluronic Acid, Platelet Rich Fibrin and Placebo: An Open Label, Randomized Controlled TrialRonald Winardi Kartika0Idrus Alwi1Franciscus D Suyatna2Em Yunir3Sarwono Waspadji4Suzana Immanuel5Saptawati Bardosono6Saleha Sungkar7Jusuf Rachmat8Mirta Hediyati9Todung Silalahi10FKUIDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Clinical Pharmacology, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Clinical Pathology, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Nutrition, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaDepartment of Clinical Parasitology, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaDepartment of Thorcic Cardiac and Vascular Surgery, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaDepartment of ENT, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaDepartment of Internal Medicine, Krida Wacana Christian University, Jakarta, IndonesiaBackground: Autologous platelet-rich fibrin (A-PRF) is an adjunctive method for diabetic foot ulcer (DFU) in addition to glycaemic control and debridement. This study aimed to evaluate the role of A-PRF + hyaluronic acid (HA), A-PRF and sodium chloride 0.9% (control) in DFU wound healing. Nowaday, the use of PRF autologous consider as adjuvant therapy in DFU treatment. Methods: This open-label randomized controlled trial was conducted at Koja District Hospital and Gatot Soebroto Hospital from July 2019 to April 2020. DFU patients with wound duration of three months, Wagner-2, and ulcer size < 40 cm2 were recruited and randomly assigned into A-PRF + AH, A-PRF and control group. On day-0, day-3 and day -7, samples and photographs were taken. Samples were analysed with ELISA and photographs were analysed with ImageJ to calculate granulation index (GI). Statistical analysis was performed using SPSS version 20. Results: Topical therapy with A-PRF + AH was associated with a significant increase in VEGF from day 0 (232.8 pg/mg) vs day 7 (544.5 pg/mg) compared to A-PRF on day 0 (185.7 pg/mg) vs day 7 (272.8 pg/mg), and the controls on day 0 (183.7 pg/mg) vs day 7 (167.4 pg/mg). On evaluation of VEGF swab, there is increasing significantly in A-PRF+HA group compare others group in day -3 ( p=0.022) and day -7 (p= 0.001).In the A-PRF + AH group, there was a significant decrease in IL-6 from day 0 (106.4 pg/mg) vs day 7 (88.7 pg/mg) compared with PRF on day 0 (91.9 pg/mg) vs day 7 (48,8 pg/mg). IL-6 was increased in the control group from day 0 (125.3 pg/mg) vs day 7 (167.9 pg/mg). On evaluation of IL-6 swab, there is decreasing significantly in A-PRF+HA group compare others group in day -7 (p= 0.041). Conclusion: The PRF + HA combination increased angiogenesis and reduced inflammation in DFUs and may represent a new DFU therapy.http://actamedindones.org/index.php/ijim/article/view/1601diabetic foot ulcerplatelet-rich fibrinhyaluronic acid |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ronald Winardi Kartika Idrus Alwi Franciscus D Suyatna Em Yunir Sarwono Waspadji Suzana Immanuel Saptawati Bardosono Saleha Sungkar Jusuf Rachmat Mirta Hediyati Todung Silalahi |
spellingShingle |
Ronald Winardi Kartika Idrus Alwi Franciscus D Suyatna Em Yunir Sarwono Waspadji Suzana Immanuel Saptawati Bardosono Saleha Sungkar Jusuf Rachmat Mirta Hediyati Todung Silalahi Wound Healing in Diabetic Foot Ulcer Patients Using Combined Use of Platelet Rich Fibrin and Hyaluronic Acid, Platelet Rich Fibrin and Placebo: An Open Label, Randomized Controlled Trial Acta Medica Indonesiana diabetic foot ulcer platelet-rich fibrin hyaluronic acid |
author_facet |
Ronald Winardi Kartika Idrus Alwi Franciscus D Suyatna Em Yunir Sarwono Waspadji Suzana Immanuel Saptawati Bardosono Saleha Sungkar Jusuf Rachmat Mirta Hediyati Todung Silalahi |
author_sort |
Ronald Winardi Kartika |
title |
Wound Healing in Diabetic Foot Ulcer Patients Using Combined Use of Platelet Rich Fibrin and Hyaluronic Acid, Platelet Rich Fibrin and Placebo: An Open Label, Randomized Controlled Trial |
title_short |
Wound Healing in Diabetic Foot Ulcer Patients Using Combined Use of Platelet Rich Fibrin and Hyaluronic Acid, Platelet Rich Fibrin and Placebo: An Open Label, Randomized Controlled Trial |
title_full |
Wound Healing in Diabetic Foot Ulcer Patients Using Combined Use of Platelet Rich Fibrin and Hyaluronic Acid, Platelet Rich Fibrin and Placebo: An Open Label, Randomized Controlled Trial |
title_fullStr |
Wound Healing in Diabetic Foot Ulcer Patients Using Combined Use of Platelet Rich Fibrin and Hyaluronic Acid, Platelet Rich Fibrin and Placebo: An Open Label, Randomized Controlled Trial |
title_full_unstemmed |
Wound Healing in Diabetic Foot Ulcer Patients Using Combined Use of Platelet Rich Fibrin and Hyaluronic Acid, Platelet Rich Fibrin and Placebo: An Open Label, Randomized Controlled Trial |
title_sort |
wound healing in diabetic foot ulcer patients using combined use of platelet rich fibrin and hyaluronic acid, platelet rich fibrin and placebo: an open label, randomized controlled trial |
publisher |
Interna Publishing |
series |
Acta Medica Indonesiana |
issn |
0125-9326 2338-2732 |
publishDate |
2021-07-01 |
description |
Background: Autologous platelet-rich fibrin (A-PRF) is an adjunctive method for diabetic foot ulcer (DFU) in addition to glycaemic control and debridement. This study aimed to evaluate the role of A-PRF + hyaluronic acid (HA), A-PRF and sodium chloride 0.9% (control) in DFU wound healing. Nowaday, the use of PRF autologous consider as adjuvant therapy in DFU treatment. Methods: This open-label randomized controlled trial was conducted at Koja District Hospital and Gatot Soebroto Hospital from July 2019 to April 2020. DFU patients with wound duration of three months, Wagner-2, and ulcer size < 40 cm2 were recruited and randomly assigned into A-PRF + AH, A-PRF and control group. On day-0, day-3 and day -7, samples and photographs were taken. Samples were analysed with ELISA and photographs were analysed with ImageJ to calculate granulation index (GI). Statistical analysis was performed using SPSS version 20. Results: Topical therapy with A-PRF + AH was associated with a significant increase in VEGF from day 0 (232.8 pg/mg) vs day 7 (544.5 pg/mg) compared to A-PRF on day 0 (185.7 pg/mg) vs day 7 (272.8 pg/mg), and the controls on day 0 (183.7 pg/mg) vs day 7 (167.4 pg/mg). On evaluation of VEGF swab, there is increasing significantly in A-PRF+HA group compare others group in day -3 ( p=0.022) and day -7 (p= 0.001).In the A-PRF + AH group, there was a significant decrease in IL-6 from day 0 (106.4 pg/mg) vs day 7 (88.7 pg/mg) compared with PRF on day 0 (91.9 pg/mg) vs day 7 (48,8 pg/mg). IL-6 was increased in the control group from day 0 (125.3 pg/mg) vs day 7 (167.9 pg/mg). On evaluation of IL-6 swab, there is decreasing significantly in A-PRF+HA group compare others group in day -7 (p= 0.041). Conclusion: The PRF + HA combination increased angiogenesis and reduced inflammation in DFUs and may represent a new DFU therapy. |
topic |
diabetic foot ulcer platelet-rich fibrin hyaluronic acid |
url |
http://actamedindones.org/index.php/ijim/article/view/1601 |
work_keys_str_mv |
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