Efficient Rapid Wound Improvement in the LTAC Setting with Autologous Platelet Rich Plasma

Purpose: Long term acute care (LTAC) hospitals have patients with non-healing wounds and significant co-morbidities which complicate the wound repair process. A patient’s wound must progress adequately in 25 days of hospitalization to support timely discharge or the patient may become a cost burden for the hospital. This study was to determine whether using autologous platelet rich plasma gel* (PRP Gel) to treat the wounds would accomplish this goal.

Methodology: Patient age, albumin, hemoglobin, previous wound duration, and objective wound measurements were prospectively gathered to determine wound area, volume, amount of undermining, sinus tracts & tunneling (ST/T). PRP Gel contains the patient’s growth factors, cytokines, and chemokines for cell growth and migration, plasma-derived proteins to produce a fibrin matrix scaffold and anti-inflammatory properties to progress the natural healing process.  

Results: Twenty two patients with 31 wounds were treated in 8 LTAC sites. Wound etiology included: 17 pressure ulcers, 4 venous ulcers, 4 trauma wounds, 3 diabetic ulcers, and 3 wound dehiscence. The mean patient age was 59.3 years and previous wound duration was 34 weeks. All the following data reflects the mean outcomes. In 3.3 treatments over 2 weeks, 87.1% of wounds decreased 56.5% in volume, 77.4% of the wounds reduced 48.6% in area. 100% of the wounds with undermining, sinus tracts or tunneling responded positively. Wounds with undermining (15/31 or 48%) had a mean reduction of 68.6% in 3.1 treatments over 1.6 weeks. Wounds with sinus tracts/tunneling (8/31 or 25.8%) had a mean reduction of 32.3% in 2.5 treatments over 1.4 weeks. Many of these patients had albumin and hemoglobin below normal.

Conclusion: Rapid size reduction in long standing wounds in compromised patients utilizing PRP Gel allowed the staff to achieve their near term goal of progressing healing and a timely patient discharge.