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Use of autologous platelet rich fibrin-based bioactive membrane in pressure ulcer healing in rats

01 April 2019

Abstract

Objective:

To verify the feasibility of treating pressure ulcers (PUs) with autologous platelet-rich fibrin-based (PRF) bioactive membrane, both in vitro and in vivo.

Method:

An animal model using adult male Sprague-Dawley rats was used. Pressure was periodically exerted on the skin to induce localised ischaemia by using an external magnet and transplanted metal disc. After a PU developed, the rats were divided into two groups: a treatment group and a control group. Rats in the treatment group were then treated with PRF bioactive membrane every three days.

Results:

A total of 20 rats were used in this study. At days three and seven, the PU area in the PRF bioactive membrane-treated group was significantly smaller than that in the control group, and after 14 days of treatment, the PUs in the PRF bioactive membrane treatment group had healed. Haemotoxylin and eosin staining, immunohistochemistry and Western blot results indicated that PRF bioactive membrane induced wound healing by increasing the thickness of the regenerated epidermis and by upregulating vascular endothelial growth factor expression. Further, we found that different concentrations of rat autologous PRF soluble factors extraction components could significantly promote rat aortic endothelial cell proliferation, wound healing and migration ability in vitro.

Conclusion:

Overall, results indicate that PRF bioactive membrane promotes PU healing in rats. Thus, it may represent a natural and effective wound-healing tool for use in the treatment of clinical skin PUs in humans in the future.

Pressure ulcers (PU) are generally defined as any lesion involving the skin, subcutaneous tissue, muscle and/or bone. A PU usually occurs over a bony prominence in long-term, bed-bound patients. A PU can develop within 24 hours as a result of pressure alone or pressure combined with shear and/or friction, and may take as long as five days to appear.1

The intensive care unit (ICU) is generally the hospital department to care for patients who have failure of one or more vital organs or haemodynamic instability. Such patients require specialist intensive medical care and continuous nursing and monitoring. Thus, the ICU is a environment favourable to the emergence of PUs.2,3 The published rate of PUs in ICU patients ranges from <1% to >50%, with an estimated 63% mortality rate for patients with PUs in the ICU.4,56

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