Wound Healing in Diabetic Foot Ulcer Patients Using Combined Use of Platelet Rich Fibrin and Hyaluronic Acid, Platelet Rich Fibrin and Placebo: An Open Label, Randomized Controlled Trial

Authors

  • Ronald Winardi Kartika FKUI
  • Idrus Alwi Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Franciscus D Suyatna Department of Clinical Pharmacology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
  • Em Yunir Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Sarwono Waspadji Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Suzana Immanuel Department of Clinical Pathology, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Saptawati Bardosono Department of Nutrition, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
  • Saleha Sungkar Department of Clinical Parasitology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
  • Jusuf Rachmat Department of Thorcic Cardiac and Vascular Surgery, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
  • Mirta Hediyati Department of ENT, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
  • Todung Silalahi Department of Internal Medicine, Krida Wacana Christian University, Jakarta, Indonesia

Keywords:

diabetic foot ulcer, platelet-rich fibrin, hyaluronic acid

Abstract

Background: Autologous platelet-rich fibrin (A-PRF) is an adjunctive method for diabetic foot ulcer (DFU) in addition to glycaemic control and debridement. This study aimed to evaluate the role of A-PRF + hyaluronic acid (HA), A-PRF and sodium chloride 0.9% (control) in DFU wound healing. Nowaday, the use of  PRF autologous consider as adjuvant therapy in DFU treatment. Methods: This open-label randomized controlled trial was conducted at Koja District Hospital and Gatot Soebroto Hospital from July 2019 to April 2020. DFU patients with wound duration of three months, Wagner-2, and ulcer size < 40 cm2 were recruited and randomly assigned into A-PRF + AH, A-PRF and control group. On day-0, day-3 and day -7, samples and photographs were taken. Samples were analysed with ELISA and photographs were analysed with ImageJ to calculate granulation index (GI). Statistical analysis was performed using SPSS version 20. Results: Topical therapy with A-PRF + AH was associated with a significant increase in VEGF from day 0 (232.8 pg/mg) vs day 7 (544.5 pg/mg) compared to A-PRF on day 0 (185.7 pg/mg) vs day 7 (272.8 pg/mg), and the controls on day 0 (183.7 pg/mg) vs day 7 (167.4 pg/mg). On evaluation  of VEGF swab, there is increasing significantly in A-PRF+HA group compare others group in day -3 ( p=0.022) and day -7 (p= 0.001).In the A-PRF + AH group, there was a significant decrease in IL-6 from day 0 (106.4 pg/mg) vs day 7 (88.7 pg/mg) compared with PRF on day 0 (91.9 pg/mg) vs day 7 (48,8 pg/mg). IL-6 was increased in the control group from day 0 (125.3 pg/mg) vs day 7 (167.9 pg/mg). On evaluation  of IL-6 swab, there is decreasing significantly in A-PRF+HA group compare others group in day -7 (p= 0.041). Conclusion: The PRF + HA combination increased angiogenesis and reduced inflammation in DFUs and may represent a new DFU therapy.

Author Biography

Ronald Winardi Kartika, FKUI

I am interest in bioinformatika

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Published

2021-10-04

How to Cite

Kartika, R. W., Alwi, I., Suyatna, F. D., Yunir, E., Waspadji, S., Immanuel, S., Bardosono, S., Sungkar, S., Rachmat, J., Hediyati, M., & Silalahi, T. (2021). Wound Healing in Diabetic Foot Ulcer Patients Using Combined Use of Platelet Rich Fibrin and Hyaluronic Acid, Platelet Rich Fibrin and Placebo: An Open Label, Randomized Controlled Trial. Acta Medica Indonesiana, 53(3), 268. Retrieved from http://actamedindones.org/index.php/ijim/article/view/1601

Issue

Vol. 53 No. 3 (2021): Acta Medica Indonesiana

Section

ORIGINAL ARTICLE

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