Chronic Wound care Diabetic Wound Healing
A chronic wound develops when progression through the normal phases of wound healing goes awry, creating a hostile environment with elevated levels of pro-inflammatory cytokines, increased matrix metalloproteinases (MMPs), destruction of extracellular matrix (ECM) components, and diminished activity of growth factors and other soluble mediators.
How PRP Heals
Platelets contain alpha granules, which harbor numerous proteins, cytokines, and growth factors. The normal wound healing process initiates with clot formation and degranulation of Platelets to release growth factors thus induction of fibroblast proliferation . The surrounding fibroblasts produces collagen for ECM formation over which the fibroblast migration occurs.
In chronic wounds, the collagen based ECM structure goes haywire due to the higher production of certain MMPs (Matrix metalloproteinases) and robust inflammation which avoid the fibroblast outgrowth. The Fibroblast produced native collagen will be degraded by MMPs produced at wound bed that stops the wound healing.
PRP produces several growth factors for induction of Fibroblast activity (Production of collagen) and proliferation required for wound closure . When mixed with PRP, collagen acts as s suicidal molecule to nullify the MMP effect of collagen degradation and native collagen forms a ECM for fibroblast proliferation and migration.
The Leukocyte Rich PRP acts as an excellent anti biotic when applied directly onto the infected wound. Some studies proven the efficacy of PRP in healing osteomyelitis with Antibiotic resistance organisms.
Conclusively PRP with collagen combination will provide excellent results in chronic wounds even with infection.
