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

1.
Kartika RW, Alwi I, Suyatna FD, Yunir E, Waspadji S, Immanuel S, Bardosono S, Sungkar S, Rachmat J, Hediyati M, Silalahi T. 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 Med Indones [Internet]. 2021Oct.4 [cited 2026Oct.21];53(3):268. Available from: https://www.actamedindones.org/index.php/ijim/article/view/1601

Issue

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

Section

ORIGINAL ARTICLE

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