Challenges in the Topical Application of Platelet-Rich Plasma

Background: The use of autologous platelet-rich plasma (PRP) in the treatment of chronic wounds is increasing. To apply PRP as a topical gel, initial activation of the platelets is required for release of growth factors and, as well as to transform PRP from a liquid to semi-solid gel. In one particular study undertaken at a tertiary wound care clinic, the application of activated PRP would often drain off the edge of the wound. Additionally, the dual syringe (PRP and CaCl/thrombin) applicator intended for use in the study dispensed the activated PRP at a slow drip.

Methods: The investigative team had to develop a method to apply the PRP in an efficient and timely manner. The study called for application of PRP to the wound for 4 consecutive visits. At each visit, the wound border was outlined on a clear acrylic dressing. Activated PRP was then carefully deposited using the dual syringe applicator within the borders of the outline on the adhesive side of the dressing. The resulting PRP gel was therefore formed in the shape of the wound to which it was applied. Participants in the study suffered from diabetic, venous and pressure ulcers. These wounds were on various anatomical locations. The maneuver to place the dressing with the pre-shaped PRP gel was initially difficult as the PRP would often shift on the dressing during placement over a wound.

Results: The efficiency of application improved with each successive treatment. All participants of the study exhibited accelerated healing with 3 subjects healing completely.

Conclusion: As the prevalence of PRP use in chronic wound care treatment increases, better methods of application must be developed. Formation of a PRP gel on clear acrylic dressing in the shape of a wound allows for efficient topical application in the treatment of chronic wounds.