Vol. 8, Issue 3, Part A (2024)

Methodology: This was a prospective randomized clinical trial conducted on 60 patients with chronic leg/foot ulcers due to Diabetes, trauma and varicosity of veins. It was conducted to compare the efficacy of platelet rich plasma versus the conventional method of graft fixation, i.e., surgical suture and surgical staples. Study population was divided into 2 equal groups of 30 patients each. Majority of the patients were put on antibiotic cover as per the culture and sensitivity reports. Daily dressings were done prior to grafting till repeat cultures showed no growth. This study had a similar distribution of patients in terms of age, sex, size of ulcer, type of ulcer and bacterial load.

Results: Most of the patients were in 4^th and 6^th decade of life. All ulcer sizes in both groups varied equal to and above 4 cm² and largest measuring 10 cm². Swab cultures were taken from all ulcers at the time of admission and after dressings. All patients were put on appropriate antibiotic therapy according to culture and sensitivity report before the STSG. Organisms encountered were Klebsiella, Escherichia coli, Pseudomonas Aeruginosa, Staphylococcus, Streptococcus and one case of MRSA. Post-operative complications (seroma and hematoma formation) were less in the PRP group compared to the Conventional group. 100% Graft uptake was achieved faster with STSG fixation using PRP in comparison to the conventional group (POD5 vs POD8, 50% of the patients had 100% graft uptake). Number of days of hospital stay and cost of treatment were significantly shorter in the PRP group when compared to the Conventional group. In this study, we have observed that post STSG, seroma and/or hematoma formation was more in the conventional group than in the PRP group. In the PRP group, out of the 30 patients, only 2 patients had hematoma formations and 18 patients had no seroma/ hematoma formation at the time of the first dressing and by the 5^th post-operative day 100% of the patients had no complications. Whereas, in the conventional group after 6 days post STSG, only 50% of the patients had no complications. 

Conclusion: Finally the study concluded that PRP can be considered as a better option to the conventional method (suture/staple) in fixation of STSG and is a rapid and safe method of management of all patients with chronic leg/foot ulcers of diabetic, traumatic, and venous origin.