PMC4979162_01
The gross appearance of the ulcer on the right leg and the application of PRP and the gelatin sheet. (a) Non-healing ulcer 26 x16 mm in size formed in the skin graft. (b) Activated PRP was applied. (c) The gelatin sheet was applied on the wound. PRP indicates platelet-rich plasma.
eplasty16e22_fig1.jpg
PMC4979162_01_eplasty16e22_fig1.jpg
F1
The present ulcer had not healed for 2 months at her initial visit to our hospital (Fig 1a). After debridement of the necrotic tissue, 2 mL of the activated PRP was applied on the ulcer (Fig 1b), and the gelatin sheet was laid to impregnate with the PRP (Fig 1c), after which the sheet was covered with the polyurethane film (OPSITE, Smith & Nephew KK, Tokyo, Japan) for 5 days.
The gross appearance of the ulcer and the color-coded image of FLPI-2 before and after PRP application. The gross appearance (a) and the color-coded image (b) of the ulcer after debridement before PRP application. The mean flux was 337 in the ulcer indicated by the white doted circle. The gross appearance (c) and the color-coded image (d) of the ulcer after removing the sheet at 5 days after application. The mean flux was 625 in the ulcer indicated by the white doted circle. PRP indicates platelet-rich plasma.
eplasty16e22_fig2.jpg
PMC4979162_01_eplasty16e22_fig2.jpg
F2
The granulation tissue formation was poor after debridement (Fig 2a), and the mean flux was 337, indicating moderate blood flow (Fig 2b). Five days after the application of PRP, granulation tissue began to form over the wound (Fig 2c) and the mean flux increased to 625 (Fig 2d).
The gross appearance of freeze-dried PRP and its application to the wound. (a) Freeze-dried PRP preserved in a 1.5-mL microcentrifuge tube. (b) Freeze-dried PRP was reconstituted to the original PRP volume with the normal saline solution, and 2 mL of reconstituted PRP was applied and covered with a gelatin sheet. PRP indicates platelet-rich plasma.
eplasty16e22_fig3.jpg
PMC4979162_01_eplasty16e22_fig3.jpg
F3
Thirty-three days after the first PRP application, freeze-dried PRP (Fig 3a) was reconstituted, and 2 mL of the reconstituted PRP was applied, covered with the gelatin sheet (Fig 3b), and then covered with the polyurethane film.
The gross appearance of the wound at 37 days (a) and 9 months (b) after the first PRP application. (a) Fourteen days after freeze-dried PRP application (37 days after the first application), more than half of the wound was epithelialized, and the rest of the wound was covered with granulation tissue. (b) The wound has no recurrent ulceration after 9 months. PRP indicates platelet-rich plasma.
eplasty16e22_fig4.jpg
PMC4979162_01_eplasty16e22_fig4.jpg
F4
Fourteen days after the freeze-dried PRP application, the wound had mostly epithelized and the rest of the wound was covered with granulation tissue (Fig 4a). The wound has had no recurrent ulceration in the 9 months that have passed since the procedure (Fig 4b).