Crovetti G, Martinelli G, Issi M, Barone M, Guizzardi M, Campanati B, Moroni M, Carabelli A, et al.
Transfusion and apheresis science : official journal of the World Apheresis Association : offic.... Date of publication 2004 Apr 1;volume 30(2):145-51.
1. Transfus Apher Sci. 2004 Apr;30(2):145-51.
Platelet gel for healing cutaneous chronic wounds.
Crovetti G(1), Martinelli G, Issi M, Barone M, Guizzardi M, Campanati B, Moroni
M, Carabelli A.
Author information:
(1)Servizio di Immunoematologia e Medicina Trasfusionale, Azienda Ospedaliera
Ospedale di Circolo di Busto Arsizio Ple Solaro 3, 21052 Busto Arsizio, Varese,
Italy. gcrovetti@aobusto.it
Wound healing is a specific host immune response for restoration of tissue
integrity. Experimental studies demonstrated an alteration of growth factors
activity due to their reduced synthesis, increased degradation and inactivation.
In wound healing platelets play an essential role since they are rich of
alpha-granules growth factors (platelet derived growth factor--PDGF; transforming
growth factor-beta--TGF-beta; vascular endothelial growth factor--VEGF). Topical
use of platelet gel (PG), hemocomponent obtained from mix of activated platelets
and cryoprecipitate, gives the exogenous and in situ adding of growth factors
(GF). The hemocomponents are of autologous or homologous origin. We performed a
technique based on: multicomponent apheretic procedure to obtain plasma rich
platelet and cryoprecipitate; manual processing in an open system, in sterile
environment, for gel activation. Every step of the gel synthesis was checked by a
quality control programme. The therapeutic protocol consists of the once-weekly
application of PG. Progressive reduction of the wound size, granulation tissue
forming, wound bed detersion, regression and absence of infective processes were
considered for evaluating clinical response to hemotherapy. 24 patients were
enrolled. They had single or multiple cutaneous ulcers with different
ethiopathogenesis. Only 3 patients could perform autologous withdrawal; in the
others homologous hemocomponent were used, always considering suitability and
traceability criteria for transfusional use of blood. Complete response was
observed in 9 patients, 2 were subjected to cutaneous graft, 4 stopped treatment,
9 had partial response and are still receiving the treatment. In each case
granulation tissue forming increased following to the first PG applications,
while complete re-epithelization was obtained later. Pain was reduced in every
treated patient. Topical haemotherapy with PG may be considered as an adjuvant
treatment of a multidisciplinary process, useful to enhance therapy of cutaneous
ulcers.
DOI: 10.1016/j.transci.2004.01.004
PMID: 15062754 [Indexed for MEDLINE]
