(CR-051) Healing of complex wounds which remains as a persistent challenge even after revascularization: Role of Vivostat*- Platelet Rich Fibrin (PRF) Treatment

Thomas Eadington, BSc; MBChB; BVM&S; MRCVS;PG Dip (MedEd) – FY2 (Foundation year 2), Surgery, Manchester Foundation Trust; Ratul Quddus, BSc in Surgery – Final year Medical Student, MBChB course, Sheffield Medical University

Introduction: Patient with Critical Limb ischaemia (CLI) often presents with large ulcers. After revascularization, healing of ulcers remains a major challenge for a Vascular Surgeon. Diabetic foot ulcer, foot amputation wounds, some venous ulcers also display a persistent challenge of healing. Local treatment with autologous platelet rich plasma gel have been shown to promote ulcer healing by releasing Platelet Derived Growth Factor (PDGF), Transformin Growth factor–β3 (TGF- β3), Vascular Endothelial Growth Factor (VEGF). This study was designed to see if Vivostat*- PRF treatment promotes healing of chronic ulcers and improve symptoms.

Methods: Patients received Vivostat* treatment to treat chronic or non-healing vascular, diabetic, and other ulcers. 120 mls of blood was taken from the patient, processed in Vivostat* Machine, produces 6 mls of concentrate rich in platelet and fibrin. Wound were prepared surgically; concentrate gel was applied on the ulcer using a separate Vivostat* applicator machine. Wound healing was monitored clinically and with medical illustrations. Patient characteristics, details of vascular status and intervention, details of Vivostat* treatment and post treatment outcomes, were collected and analyzed.

Results: Total of 71 patients were treated with Vivostat*. Wound healing achieved in 64.7% patients (n=46). Of those, 46.4% (n=33) healed fully, 18.3% (n=13) wounds were nearly healed in a given period of time. Wounds in 18 patients (25.3%) failed to heal, 7 patients lost follow-up. Healing time ranges from 2 weeks to 5 months. All Patients experienced relief of pain and discomfort soon after the treatment.

Discussion: Vivostat*-PRF treatment promotes ulcer healing and is an effective way to treat ulcers. It provides significant patient comfort, promotes early hospital discharge. This also reduces mortality and morbidity associated with CLI, prolong hospital stay; decreases burden on health care system. Vivostat*-PRF treatment may combat the problem of persistent challenge of vascular ulcer and other wound healing.