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BioMed Research International
Volume 2013 (2013), Article ID 837620, 9 pages
http://dx.doi.org/10.1155/2013/837620
Research Article

Treatment of Nonhealing Diabetic Lower Extremity Ulcers with Skin Graft and Autologous Platelet Gel: A Case Series

1Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 11490 Taipei, Taiwan
2Department of Materials Engineering, Tatung University, 10452 Taipei, Taiwan
3Human Protein Process Sciences, 59000 Lille, France & Institute of Biomaterials and Tissue Engineering, Taipei Medical University, 11031 Taipei, Taiwan

Received 20 September 2012; Accepted 24 November 2012

Academic Editor: David G. Armstrong

Copyright © 2013 Yuan-Sheng Tzeng et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Lower extremity ulcers in diabetic patients are difficult to treat. Recently, the use of human blood platelet-derived components in this indication has been raising interest. In this study, we have evaluated the safety and efficacy of the combination of autologous platelet gel (PG) and skin graft for treating large size recalcitrant ulcers. Eight consecutive diabetic patients aged 25 to 82 with nine nonhealing lower extremity ulcers (median size of 50 cm2; range 15–150 cm2) were treated. Skin ulcer was debrided, and the wound was sprayed after 7 to 10 days with autologous platelet-rich plasma and thrombin. Thin split-thickness skin graft with multiple slits was then applied on the wound bed and fixed with staples or cat-gut sutures. There were no adverse reactions observed during the study. Eight out of 9 skin grafts took well. The interval between skin graft and complete wound healing ranged from 2 to 3 weeks in the 8 successful cases. No ulcer recurrence was noted in those patients during the follow-up period of 2 to 19 months. In this study, the combination of autologous platelet gel and skin grafting has proven beneficial to heal large-size recalcitrant ulcers.