الفهرس 
THE ELEMENTS OF WOUND HEALINGOnly 14 pages are availabe for public view
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Abstract
Chronic wounds cause patients severe emotional and physical stress as well as creating a significant financial burden on patients and the whole healthcare system.
The vast majority of chronic wounds can be classified into three categories: venous ulcers, diabetic, and pressure ulcers. In chronic wounds, the formation and release of growth factors may be prevented, the factors may be sequestered and unable to perform their metabolic roles, or degraded in excess by cellular or bacterial proteases.
Patients with diabetes are at an increased risk for developing foot ulcerations. The consequences of persistent and poorly controlled hyperglycemia lead to neuropathic and vascular abnormalities that cause foot deformities and ulceration.
The feet of diabetic patients should be examined at least annually to determine predisposing conditions to ulceration.
The platelet releasate is a mixture of autologous growth factors obtained from the patient’s own blood. These factors are critical in the regulation and stimulation of the wound healing process, and they play an important role in regulating cellular processes.
The purpose of this prospective clinical study was to evaluate the efficacy of platelet releasate for the treatment of chronic non healing diabetic foot ulcers.
The study was carried on thirty six diabetic ulcers in controlled diabetic patients between the age of 40 and 60 years following the inclusion and exclusion criteria set.
The patients were divided into three groups; the first group (study group) were twelve patients, having platelet rich plasma (platelet gel/platelet releasate), as their dressing protocol and the second group (control group) were twelve patients, having platelet poor plasma, as their dressing protocol and the third group (study group) were twelve patients, having dressing containing oxidized regenerated cellulose (ORC) and collagen as the active ingredients, as their dressing protocol.
The patients were followed up twice weekly and laboratory investigations were done once monthly and both clinical and laboratory data were documented until healing of the ulcer or up to 20 weeks.
Statistical analysis was done for the collected data, which showed that 12 cases (100%) of 1st study group (platelet rich plasma), healed completely by the end of 20 weeks., 9 cases (75%) of 2nd control group (platelet poor plasma) healed completely by the end of 20 weeks and 8 cases (66.7%) of the 3rd study group (Promogran) healed completely by the end of 20 weeks.
There were several statistical significant points in the study; healing was significantly faster in PRP group in comparison to the other two groups, healing time rate was highest in the PRP group followed by Promogran group and platelet poor plasma at the end.
Also Promogran group is better than PRP group and PPP group in leaving the patients with no bad odor. Moreover pain relief was faster in PRP group followed by Promogran and platelet poor plasma at the end.
In this study, PRP proves to be effective treatment for diabetic foot ulceration thus to be enrolled as one of the efficient wound healing modalities and Promogran is an alternative smart dressing that can be used in the management of diabetic foot ulcers.