J Korean Foot Ankle Soc.  2022 Dec;26(4):187-191. 10.14193/jkfas.2022.26.4.187.

Intralesional Injection of Autologous Platelet-Rich Plasma as an Effective Regeneration Therapy: A Case Report of Chronic Wagner Grade 2 Diabetic Foot Ulcer

• Kim MH

• KMID: 2536715
• DOI: http://doi.org/10.14193/jkfas.2022.26.4.187

Abstract

The author experienced a case of autologous platelet-rich plasma (PRP) affecting the recovery of a chronic neuropathic diabetic foot ulcer combined with infection. A 65-year-aged male with uncontrolled diabetes presented with a Wagner grade 2 diabetic foot ulcer on his left forefoot of more than 2 weeks duration. Osteomyelitis, gangrene, and ischemia requiring acute intervention were absent. Although infection was controlled to a moderate degree, wound healing was unsatisfactory following surgical debridement and simple dressing. Therefore, intralesional autologous PRP injection was performed 5 times as an adjuvant regeneration therapy, and the recalcitrant ulcer healed in 3 months. Intralesional PRP injections are worthwhile as they promote wound regeneration, are evidence-based, safe, and can be easily performed in ambulatory care facilities.

Keyword

Diabetic foot ulcer; Platelet-rich plasma; International Working Group on the Diabetic Foot; Wound regeneration

Figure

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  Figure 1 Local appearances of a diabetic foot ulcer. (A) First visit. (B) Two days after the first visit. The subcutaneous abscess with purulent discharge in the inflammation area became to conglomerated to ulcer.

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  Figure 2 Change of the diabetic foot ulcer after intralesional autologous platelet-rich plasma (PRP) injection. (A) Five days after the 2nd PRP injection. (B) Twelve days after the 4th PRP injection. (C) Thirteen days after the 4th PRP injection.

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  Figure 3 Photographs of procedure. (A, B) Fifth platelet-rich plasma (PRP) intralesional injection into the Wagner grade 2 diabetic foot ulcer on the left forefoot. (C, D) PRP gel was applied to the superficial wounds on the opposite toes.

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  Figure 4 Photographs taken when the patient visit the clinic 6 weeks after the 5th platelet-rich plasma (PRP) injection. (A) Within 3 months from the first visit, the chronicized Wagner grade 2 diabetic foot ulcer was healed completely with no defect. (B) Superficial wounds on the opposite toes were healed in 3 weeks after PRP gel with hydrocolloid bandage application.

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