References
Platelet-rich plasma, bilayered acellular matrix grafting and negative pressure wound therapy in diabetic foot infection
Abstract
Management and treatment of acute severe diabetic foot disease in patients with suboptimal glycaemic control is a critical issue in wound repair. This paper discusses the clinical efficacy of an aggressive surgical intervention combined with targeted use of regenerative medical therapies in limb preservation. Negative pressure wound therapy (NPWT), platelet-rich plasma (PRP), bilayered acellular matrix grafting and split-thickness skin grafting were combined to treat a patient with diabetes, foot necrotising fasciitis and gaseous gangrene. The wound was completely healed. The clinical outcome revealed that a multi-intervention strategy could be effective for large necrotising fasciitis wounds. Early clinical observation, suggests aggresive surgical intervention preserving intact tissue and targeted use of new regenerative technologies can lead to preservation of a limb.
Patients with diabetes that is under suboptimal control presenting with an infection are at high risk of amputation.1,2 Necrotising fasciitis a rapidly progressive acute diease, often assoicated with diabetes, it is an important cause of morbidity and mortality in these patients with diabetes.3,4 When glycaemic control is poor the rate of amputation and morality in the presence of necrotising fasciitis increases.3,5 Given the potential for amputation along with increased morbidity in patients with comorbidities, different advanced wound-treatment technologies could be useful for healing of challenging soft tissue defects caused by radical debridement of necrotising fasciitis.6 Platelet-rich plasma (PRP) includes a platelet concentration about three to six times above a normal level and a myriad of growth factors and cytokines that, when concentrated, could promote wound healing and tissue regeneration. It may have a promising effect on promotion of both low extremity refractory wound healing,7 as well as in patients following debridement of severely infected wounds.8
Register now to continue reading
Thank you for visiting Wound Central and reading some of our peer-reviewed resources for wound care professionals. To read more, please register today. You’ll enjoy the following great benefits:
What's included
-
Access to clinical or professional articles
-
New content and clinical updates each month