A Comparative study on the Efficacy of Topical Autohemotherapy Versus Topical Autologous Platelet Rich Plasma in Chronic Venous Ulcers

BACKGROUND: Chronic venous ulcers, the most common cause of lower limb ulceration is emerging as a major public health challenge with morbidity and significant impact on the quality of life. Wound healing in these patients is a complex process which is regulated by the interaction between various cell types, extracellular matrix, cytokines and growth factors. Topical autohemotherapy and topical autologous platelet rich plasma (PRP) are simple office based procedure which helps in enhancing the wound healing. AIM OF THE STUDY: To compare the efficacy of topical autohemotherapy and topical autologous platelet rich plasma in the healing of chronic leg ulcers due to venous stasis by estimating the change in the ulcer area and volume after treatment. METHODOLOGY: 36 patients with 40 venous ulcers were randomly divided into two group and each group was treated with topical autohemotherapy and autologous PRP respectively and treatment outcome was measured by percentage of improvement in area and volume of the ulcer. RESULTS: 18 patients with 22 ulcers were treated with autohemotherapy and 18 patients with 18 ulcers were treated with PRP. The median age of the patients was 49.5 years. 34 were males and 2 were females. The mean duration of the ulcers was 4.23 months. The percentage of improvement in the mean area at the end of six weeks following treatment with autohemotherapy and autologous platelet rich plasma was 88.4% and 85% respectively (p=0.45). The percentage of improvement in the mean volume at the end of six weeks following treatment with autohemotherapy and autologous platelet rich plasma was 97.9 % and 88.4% respectively (p=0.1). CONCLUSIONS: Both topical autohemotherapy and topical autologous PRP are safe, office based procedures in treating chronic venous ulcers, Topical autohemotherapy is a simpler, cost effective, less time consuming procedure and does not require sophisticated equipment and hence may be considered as a primary treatment modality in the management of chronic venous ulcers in resource poor settings