Experiencia con el uso de plasma rico en plaquetas autólogo en el tratamiento de las úlceras del pie diabético
Palabras clave:
PIE DIABÉTICO, ÚLCERA DEL PIE, FACTOR DE CRECIMIENTO DERIVADO DE PLAQUETAS, PLASMA RICO EN PLAQUETAS
Resumen
Las úlceras de pie diabético (UPD) generan un alto costo para el paciente y el sistema de salud. Una deficiente vascularización, la inhibición de la generación de factores de crecimiento y la migración celular, entre otros factores, influyen en su cronicidad. Los factores de crecimiento derivados de las plaquetas (PDGF) estimulan la quimiotaxis, la neovascularización y la regeneración tisular.
Objetivo: evaluar la efectividad de una formulación de plasma rico en plaquetas autólogo (PRP) como una modalidad complementaria para el tratamiento de UPD, valorando su seguridad y efectos adversos.
Materiales: estudio observacional. Se aplicó PRP a seis pacientes con UPD crónicas, Wagner II, III, con una media en el retraso de la cicatrización de 94 semanas. Se administró mediante punción y como gel sobre la lesión una vez por semana hasta el cierre de la úlcera o durante12 semanas. Las UPD se analizaron con respecto al área y su progresión mediante Mobile Wound Analyzer (MOWA), software de análisis de imágenes de úlceras. El porcentaje de reducción del área se calculó entre la medición inicial y la semana 12. Como criterio de mejoría se eligió una reducción >70% de la lesión.
Resultados: predominó el sexo masculino con una media de edad de 53 años ± 7,3. Luego de 12 semanas de tratamiento, se reportó una reducción media del tamaño de la úlcera de 78%, con dos cicatrizaciones completas y dos en 99%. Un paciente recibió una amputación luego de presentar infección no controlada.
Conclusión: la aplicación del PRP mejoró la regeneración de tejidos, acortando la duración de la úlcera, promoviendo su curación sin efectos adversos, al tiempo que eliminó la necesidad de procedimientos de manejo en una úlcera crónica.
Citas
1) Boulton AJ. The diabetic foot: a global view. Diabetes Metab Res Rev 2000; 16(Suppl 1):S2-5. doi: 10.1002/1520-7560 (200009/10)16:1+3.0.co;2-n
2) Tzeng YS, Deng SC, Wang CH, Tsai JC, Chen TM, Burnouf T. Treatment of nonhealing diabetic lower extremity ulcers with skin graft and autologous platelet gel: a case series. Biomed Res Int 2013; 2013:837620.
3) Guest JF, Fuller GW, Vowden P. Diabetic foot ulcer management in clinical practice in the UK: costs and outcomes. Int Wound J 2018; 15(1):43-52.
4) Lavery LA, Davis KE, Berriman SJ, Braun L, Nichols A, Kim PJ, et al. WHS guidelines update: diabetic foot ulcer treatment guidelines. Wound Repair Regen 2016; 24:112-26.
5) Wu SC, Driver VR, Wrobel JS, Armstrong DG. Foot ulcers in the diabetic patient, prevention and treatment. Vasc Health Risk Manag 2007; 3(1):65-76.
6) Raeissadat SA, Rayegani SM, Hassanabadi H, Fathi M, Ghorbani E, Babaee M, et al. Knee osteoarthritis injection choices: Platelet-rich plasma (PRP) versus hyaluronic acid (A one-year randomized clinical trial). Clin Med Insights Arthritis Musculoskeletal Disord 2015; 8:1-8. doi: 10.4137/ CMAMD.S17894.
7) Knighton DR, Doucette M, Fiegel VD, Ciresi K, Butler E, Austin L. The use of platelet derived wound healing formula in human clinical trials. Prog Clin Biol Res 1988; 266:319-29.
8) Knighton DR, Ciresi K, Fiegel VD, Schumerth S, Butler E, Cerra F. Stimulation of repair in chronic, nonhealing, cutaneous ulcers using platelet]derived wound healing formula. Surg Gynecol Obstet 1990; 170(1):56-60.
9) Paknejad M, Shayesteh YS, Yaghobee S, Shariat S, Dehghan M, Motahari P. Evaluation of the effect of plasma rich in growth factors (PRGF) on bone regeneration. J Dent (Tehran) 2012; 9(1):59-67.
10) Driver VR, Hanft J, Fylling CP, Beriou JM; Autologel Diabetic Foot Ulcer Study Group. A prospective, randomized, controlled trial of autologous platelet]rich plasma gel for the treatment of diabetic foot ulcers. Ostomy Wound Manage 2006; 52(6):68-74.
11) Anitua E, Aguirre JJ, Algorta J, Ayerdi E, Cabezas AI, Orive G, Andia I. Effectiveness of autologous preparation rich in growth factors for the treatment of chronic cutaneous ulcers. J Biomed Mater Res B Appl Biomater 2008; 84(2):415-21.
12) Li L, Wang C, Wang Y, He LP, Yang YZ, Chen LH, et al. Impact of topical application of autologous platelet]rich gel on medical expenditure and length of stay in hospitals in diabetic patients with refractory cutaneous ulcers. Sichuan Da Xue Xue Bao Yi Xue Ban 2012; 43(5):762-5.
13) Martinez-Zapata MJ, Martí-Carbajal AJ, Solà I, Expósito JA, Bolíbar I, Rodríguez L, et al. Autologous platelet-rich plasma for treating chronic wounds. Cochrane Database Syst Rev 2016; (5):CD006899.
14) Hu Z, Qu S, Zhang J, Cao X, Wang P, Huang S, et al. Efficacy and safety of platelet-rich plasma for patients with diabetic ulcers: a systematic review and meta-analysis. Adv Wound Care (New Rochelle) 2019; 8(7):298-308. doi:10.1089/wound.2018.0842.
15) Houdek MT, Wyles CC, Stalboerger PG, Terzic A, Behfar A, Moran SL. Collagen and fractionated platelet-rich plasma scaffold for dermal regeneration. Plast Reconstr Surg 2016; 137:1498-1506.
16) Picard F, Hersant B, Bosc R, Meningaud JP. The growing evidence for the use of platelet-rich plasma on diabetic chronic wounds: a review and a proposal for a new standard care. Wound Repair Regen 2015; 23(5):638-43. doi: 10.1111/ wrr.12317.
17) Mohammadi MH, Molavi B, Mohammadi S, Nikbakht M, Mohammadi AM, Mostafaei S, et al. Evaluation of wound healing in diabetic foot ulcer using platelet-rich plasma gel: a single-arm clinical trial. Transfus Apher Sci 2017; 56(2):160-4. doi: 10.1016/j.transci.2016.10.020.
18) Rodriguez AE, Gisbert S, Palazón A, Alio JL. Quantification of growth factors and fibronectin in diverse preparations of platelet-rich plasma for the treatment of ocular surface disorders (E-PRP). Transl Vis Sci Technol 2020; 9(6):22. doi: 10.1167/tvst.9.6.22.
19) Huang Y, Xie T, Cao Y, Wu M, Yu L, Lu S, et al. Comparison of two classification systems in predicting the outcome of diabetic foot ulcers: the Wagner grade and the Saint Elian Wound score systems. Wound Repair Regen 2015; 23(3):379-85. doi: 10.1111/wrr.12289.
20) Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Harkless LB, Boulton AJ. A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care 2001; 24(1):84-8. doi: 10.2337/diacare.24.1.84.
21) Kontopodis N, Tavlas E, Papadopoulos G, Pantidis D, Kafetzakis A, Chalkiadakis G, et al. Effectiveness of platelet-rich plasma to enhance healing of diabetic foot ulcers in patients with concomitant peripheral arterial disease and critical limb ischemia. Int J Low Extrem Wounds 2016; 15(1):45-51. doi: 10.1177/1534734615575829.
22) Furst G, Gruber R, Tangl S, Zechner W, Haas R, Mailath G, et al. Sinus grafting with autogenous platelet- rich plasma and bovine hidroxyapatite: a histomorfometric study in minipigs. Clin Oral Implants Res 2003; 14:500-8.
23) British Committee for Standards in Haematology, Blood Transfusion Task Force. Guidelines for the use of platelets transfusion. Brit J Haematol 2003; 122:10-23.
24) Kalish J, Hamdan A. Management of diabetic foot problems. J Vasc Surg 2010; 51(2):476-86.
25) Veves A, Falanga V, Armstrong DG, Sabolinski ML; Apligraf Diabetic Foot Ulcer Study. Graftskin, a human skin equivalent, is effective in the management of noninfected neuropathic diabetic foot ulcers: a prospective randomized multicenter clinical trial. Diabetes Care 2001; 24(2): 290-5.
26) Reyzelman A, Crews RT, Moore JC, Moore L, Mukker JS, Offutt S, et al. Clinical effectiveness of an acellular dermal regenerative tissue matrix compared to standard wound management in healing diabetic foot ulcers: a prospective, randomised, multicentre study. Int Wound J 2009; 6(3):196- 208.
27) Montón Echeverría J, Pérez Redondo S, Gómez Bajo GJ. Experiencia clínica en el empleo de factores de crecimiento autólogos obtenidos de plasma rico en plaquetas. Cir Plást Iberolatinoam 2007; 33(3):155-62. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0376-78922007000300002&lng=es.[Consulta: 14 junio 2019].
28) Scimeca CL, Bharara M, Fisher T, Kimbriel H, Armstrong D. Novel use of platelet-rich plasma to augment curative diabetic foot surgery. J Diabetes Sci Technol 2010; 4(5):1121-6.
29) Tzeng YS, Deng SC, Wang CH, Tsai JC, Chen TM, Burnouf T. Treatment of nonhealing diabetic lower extremity ulcers with skin graft and autologous platelet gel: a case series. Biomed Res Int 2013; 2013:837620.
30) Li L, Chen DW, Wang C, Yuan NB, Wang Y, He LP, et al. Autologous platelet-rich gel for treatment of diabetic chronic refractory cutaneous ulcers: A prospective, randomized clinical trial. Wound Repair Regen 2015; 23(4):495-505.
31) Yuan N, Wang C, Wang Y, Yu T, Long Y, Zhang X, Ran X. Preparation of autologous platelet-rich gel for diabetic refractory dermal ulcer and growth factors analysis from it. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2008; 22(4):468-71.
32) Frykberg RG, Driver VR, Carman D, Lucero B, BorrisHale C, Carelyn P. Chronic wounds treated with a physiologically relevant concentration of plateletrich plasma gel: a prospective case series. Ostomy Wound Manage 2010; 56(6):36-44.
33) Cervelli V, De Angelis B, Lucarini L, Spallone D, Balzani A, Palla L, et al. Tissue regeneration in loss of substance on the lower limbs through use of platelet-rich plasma, stem cells from adipose tissue, and hyaluronic acid. Adv Skin Wound Care 2010; 23(6):262-72.
34) Sakata J, Sasaki S, Handa K, Uchino T, Sasaki T, Higashita R, et al. A retrospective, longitudinal study to evaluate healing lower extremity wounds in patients with diabetes mellitus and ischemia using standard protocols of care and platelet-rich plasma gel in a Japanese wound care program. Ostomy Wound Manage 2012; 58(4):36-49.
35) Wieman TJ, Smiell JM, Su Y. Efficacy and safety of a topical gel formulation of recombinant human platelet-derived growth factor-BB (becaplermin) in patients with chronic neuropathic diabetic ulcers: a phase III randomized placebo-controlled double-blind study. Diabetes Care 1998; 21:822-7.
36) Gentzkow GD, Iwasaki SD, Hershon KS, Mengel M, Prendergast JJ, Ricotta JJ, Steed DP, Lipkin S. Use of dermagraft, a cultured human dermis, to treat diabetic foot ulcers. Diabetes Care 1996; 19:350-4.
37) Chen L, Wang C, Liu H, Liu G, Ran X. Antibacterial effect of autologous platelet-rich gel derived from subjects with diabetic dermal ulcers in vitro. J Diabetes Res 2013; 2013:269527.
38) Brigido SA, Schwartz E, McCarroll R, Hardin-Young J. Use of an acellular flowable dermal replacement scaffold on lower extremity sinus tract wounds: a retrospective series. Foot Ankle Spec 2009; 2(2):67-72.
39) Cho JW, Kim SA, Lee KS. Platelet-rich plasma induces increased expression of G1 cell cycle regulators, type I collagen, and matrix metalloproteinase-1 in human skin fibroblasts. Int J Mol Med 2012; 29:32-6.
40) Pietramaggiori G, Scherer SS, Mathews JC, Gennaoui T, Lancerotto L, Ragno G, et al. Quiescent platelets stimulate angiogenesis anddiabetic wound repair. J Surg Res 2010; 160:169-77.
41) Dougherty EJ. An evidence-based model comparing the costeffectiveness of platelet-rich plasma gel to alternative therapies for patients with nonhealing diabetic foot ulcers. Adv Skin Wound Care 2008; 21(12):568-75.
42) Kantor J, Margolis DJ. Treatment options for diabetic neuropathic foot ulcers: a cost-effectiveness analysis. Dermatologic Surg 2001; 27(4):347-51.
43) International Diabetes Federation; Ibrahim A, Jude E, Langton K, Martinez-De Jesus FR, Harkless LB, Gawish H, et al. IDF Clinical Practice Recommendation on the Diabetic Foot - 2017: a guide for health care professio nals. Brussels: IDF, 2017. Disponible en: https://www. idf.org/e-library/guidelines/119-idf-clinical-practice-recommendations-on-diabetic-foot-2017.html. [Consulta: 14 junio 2019].
44) Martins-Mendes D, Monteiro-Soares M, Boyko EJ, Ribeiro M, Barata P, Lima J, et al. The independent contribution of diabetic foot ulcer on lower extremity amputation and mortality risk. J Diabetes Complicat 2014; 28(5): 632-8.
45) Steed DL, Edington HD, Webster MW. Recurrence rate of diabetic neurotrophic foot ulcers healed using topical application of growth factors released from platelets. Wound Repair Regen 1996; 4(2):230-3. doi: 10.1046/j.1524-475X. 1996.40210.x.
46) Margolis DJ, Kantor J, Santanna J, Strom BL, Berlin JA. Effectiveness of platelet releasate for the treatment of diabetic neuropathic foot ulcers. Diabetes Care 2001; 24(3):483-8. doi: 10.2337/diacare.24.3.483.
2) Tzeng YS, Deng SC, Wang CH, Tsai JC, Chen TM, Burnouf T. Treatment of nonhealing diabetic lower extremity ulcers with skin graft and autologous platelet gel: a case series. Biomed Res Int 2013; 2013:837620.
3) Guest JF, Fuller GW, Vowden P. Diabetic foot ulcer management in clinical practice in the UK: costs and outcomes. Int Wound J 2018; 15(1):43-52.
4) Lavery LA, Davis KE, Berriman SJ, Braun L, Nichols A, Kim PJ, et al. WHS guidelines update: diabetic foot ulcer treatment guidelines. Wound Repair Regen 2016; 24:112-26.
5) Wu SC, Driver VR, Wrobel JS, Armstrong DG. Foot ulcers in the diabetic patient, prevention and treatment. Vasc Health Risk Manag 2007; 3(1):65-76.
6) Raeissadat SA, Rayegani SM, Hassanabadi H, Fathi M, Ghorbani E, Babaee M, et al. Knee osteoarthritis injection choices: Platelet-rich plasma (PRP) versus hyaluronic acid (A one-year randomized clinical trial). Clin Med Insights Arthritis Musculoskeletal Disord 2015; 8:1-8. doi: 10.4137/ CMAMD.S17894.
7) Knighton DR, Doucette M, Fiegel VD, Ciresi K, Butler E, Austin L. The use of platelet derived wound healing formula in human clinical trials. Prog Clin Biol Res 1988; 266:319-29.
8) Knighton DR, Ciresi K, Fiegel VD, Schumerth S, Butler E, Cerra F. Stimulation of repair in chronic, nonhealing, cutaneous ulcers using platelet]derived wound healing formula. Surg Gynecol Obstet 1990; 170(1):56-60.
9) Paknejad M, Shayesteh YS, Yaghobee S, Shariat S, Dehghan M, Motahari P. Evaluation of the effect of plasma rich in growth factors (PRGF) on bone regeneration. J Dent (Tehran) 2012; 9(1):59-67.
10) Driver VR, Hanft J, Fylling CP, Beriou JM; Autologel Diabetic Foot Ulcer Study Group. A prospective, randomized, controlled trial of autologous platelet]rich plasma gel for the treatment of diabetic foot ulcers. Ostomy Wound Manage 2006; 52(6):68-74.
11) Anitua E, Aguirre JJ, Algorta J, Ayerdi E, Cabezas AI, Orive G, Andia I. Effectiveness of autologous preparation rich in growth factors for the treatment of chronic cutaneous ulcers. J Biomed Mater Res B Appl Biomater 2008; 84(2):415-21.
12) Li L, Wang C, Wang Y, He LP, Yang YZ, Chen LH, et al. Impact of topical application of autologous platelet]rich gel on medical expenditure and length of stay in hospitals in diabetic patients with refractory cutaneous ulcers. Sichuan Da Xue Xue Bao Yi Xue Ban 2012; 43(5):762-5.
13) Martinez-Zapata MJ, Martí-Carbajal AJ, Solà I, Expósito JA, Bolíbar I, Rodríguez L, et al. Autologous platelet-rich plasma for treating chronic wounds. Cochrane Database Syst Rev 2016; (5):CD006899.
14) Hu Z, Qu S, Zhang J, Cao X, Wang P, Huang S, et al. Efficacy and safety of platelet-rich plasma for patients with diabetic ulcers: a systematic review and meta-analysis. Adv Wound Care (New Rochelle) 2019; 8(7):298-308. doi:10.1089/wound.2018.0842.
15) Houdek MT, Wyles CC, Stalboerger PG, Terzic A, Behfar A, Moran SL. Collagen and fractionated platelet-rich plasma scaffold for dermal regeneration. Plast Reconstr Surg 2016; 137:1498-1506.
16) Picard F, Hersant B, Bosc R, Meningaud JP. The growing evidence for the use of platelet-rich plasma on diabetic chronic wounds: a review and a proposal for a new standard care. Wound Repair Regen 2015; 23(5):638-43. doi: 10.1111/ wrr.12317.
17) Mohammadi MH, Molavi B, Mohammadi S, Nikbakht M, Mohammadi AM, Mostafaei S, et al. Evaluation of wound healing in diabetic foot ulcer using platelet-rich plasma gel: a single-arm clinical trial. Transfus Apher Sci 2017; 56(2):160-4. doi: 10.1016/j.transci.2016.10.020.
18) Rodriguez AE, Gisbert S, Palazón A, Alio JL. Quantification of growth factors and fibronectin in diverse preparations of platelet-rich plasma for the treatment of ocular surface disorders (E-PRP). Transl Vis Sci Technol 2020; 9(6):22. doi: 10.1167/tvst.9.6.22.
19) Huang Y, Xie T, Cao Y, Wu M, Yu L, Lu S, et al. Comparison of two classification systems in predicting the outcome of diabetic foot ulcers: the Wagner grade and the Saint Elian Wound score systems. Wound Repair Regen 2015; 23(3):379-85. doi: 10.1111/wrr.12289.
20) Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Harkless LB, Boulton AJ. A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care 2001; 24(1):84-8. doi: 10.2337/diacare.24.1.84.
21) Kontopodis N, Tavlas E, Papadopoulos G, Pantidis D, Kafetzakis A, Chalkiadakis G, et al. Effectiveness of platelet-rich plasma to enhance healing of diabetic foot ulcers in patients with concomitant peripheral arterial disease and critical limb ischemia. Int J Low Extrem Wounds 2016; 15(1):45-51. doi: 10.1177/1534734615575829.
22) Furst G, Gruber R, Tangl S, Zechner W, Haas R, Mailath G, et al. Sinus grafting with autogenous platelet- rich plasma and bovine hidroxyapatite: a histomorfometric study in minipigs. Clin Oral Implants Res 2003; 14:500-8.
23) British Committee for Standards in Haematology, Blood Transfusion Task Force. Guidelines for the use of platelets transfusion. Brit J Haematol 2003; 122:10-23.
24) Kalish J, Hamdan A. Management of diabetic foot problems. J Vasc Surg 2010; 51(2):476-86.
25) Veves A, Falanga V, Armstrong DG, Sabolinski ML; Apligraf Diabetic Foot Ulcer Study. Graftskin, a human skin equivalent, is effective in the management of noninfected neuropathic diabetic foot ulcers: a prospective randomized multicenter clinical trial. Diabetes Care 2001; 24(2): 290-5.
26) Reyzelman A, Crews RT, Moore JC, Moore L, Mukker JS, Offutt S, et al. Clinical effectiveness of an acellular dermal regenerative tissue matrix compared to standard wound management in healing diabetic foot ulcers: a prospective, randomised, multicentre study. Int Wound J 2009; 6(3):196- 208.
27) Montón Echeverría J, Pérez Redondo S, Gómez Bajo GJ. Experiencia clínica en el empleo de factores de crecimiento autólogos obtenidos de plasma rico en plaquetas. Cir Plást Iberolatinoam 2007; 33(3):155-62. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0376-78922007000300002&lng=es.[Consulta: 14 junio 2019].
28) Scimeca CL, Bharara M, Fisher T, Kimbriel H, Armstrong D. Novel use of platelet-rich plasma to augment curative diabetic foot surgery. J Diabetes Sci Technol 2010; 4(5):1121-6.
29) Tzeng YS, Deng SC, Wang CH, Tsai JC, Chen TM, Burnouf T. Treatment of nonhealing diabetic lower extremity ulcers with skin graft and autologous platelet gel: a case series. Biomed Res Int 2013; 2013:837620.
30) Li L, Chen DW, Wang C, Yuan NB, Wang Y, He LP, et al. Autologous platelet-rich gel for treatment of diabetic chronic refractory cutaneous ulcers: A prospective, randomized clinical trial. Wound Repair Regen 2015; 23(4):495-505.
31) Yuan N, Wang C, Wang Y, Yu T, Long Y, Zhang X, Ran X. Preparation of autologous platelet-rich gel for diabetic refractory dermal ulcer and growth factors analysis from it. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2008; 22(4):468-71.
32) Frykberg RG, Driver VR, Carman D, Lucero B, BorrisHale C, Carelyn P. Chronic wounds treated with a physiologically relevant concentration of plateletrich plasma gel: a prospective case series. Ostomy Wound Manage 2010; 56(6):36-44.
33) Cervelli V, De Angelis B, Lucarini L, Spallone D, Balzani A, Palla L, et al. Tissue regeneration in loss of substance on the lower limbs through use of platelet-rich plasma, stem cells from adipose tissue, and hyaluronic acid. Adv Skin Wound Care 2010; 23(6):262-72.
34) Sakata J, Sasaki S, Handa K, Uchino T, Sasaki T, Higashita R, et al. A retrospective, longitudinal study to evaluate healing lower extremity wounds in patients with diabetes mellitus and ischemia using standard protocols of care and platelet-rich plasma gel in a Japanese wound care program. Ostomy Wound Manage 2012; 58(4):36-49.
35) Wieman TJ, Smiell JM, Su Y. Efficacy and safety of a topical gel formulation of recombinant human platelet-derived growth factor-BB (becaplermin) in patients with chronic neuropathic diabetic ulcers: a phase III randomized placebo-controlled double-blind study. Diabetes Care 1998; 21:822-7.
36) Gentzkow GD, Iwasaki SD, Hershon KS, Mengel M, Prendergast JJ, Ricotta JJ, Steed DP, Lipkin S. Use of dermagraft, a cultured human dermis, to treat diabetic foot ulcers. Diabetes Care 1996; 19:350-4.
37) Chen L, Wang C, Liu H, Liu G, Ran X. Antibacterial effect of autologous platelet-rich gel derived from subjects with diabetic dermal ulcers in vitro. J Diabetes Res 2013; 2013:269527.
38) Brigido SA, Schwartz E, McCarroll R, Hardin-Young J. Use of an acellular flowable dermal replacement scaffold on lower extremity sinus tract wounds: a retrospective series. Foot Ankle Spec 2009; 2(2):67-72.
39) Cho JW, Kim SA, Lee KS. Platelet-rich plasma induces increased expression of G1 cell cycle regulators, type I collagen, and matrix metalloproteinase-1 in human skin fibroblasts. Int J Mol Med 2012; 29:32-6.
40) Pietramaggiori G, Scherer SS, Mathews JC, Gennaoui T, Lancerotto L, Ragno G, et al. Quiescent platelets stimulate angiogenesis anddiabetic wound repair. J Surg Res 2010; 160:169-77.
41) Dougherty EJ. An evidence-based model comparing the costeffectiveness of platelet-rich plasma gel to alternative therapies for patients with nonhealing diabetic foot ulcers. Adv Skin Wound Care 2008; 21(12):568-75.
42) Kantor J, Margolis DJ. Treatment options for diabetic neuropathic foot ulcers: a cost-effectiveness analysis. Dermatologic Surg 2001; 27(4):347-51.
43) International Diabetes Federation; Ibrahim A, Jude E, Langton K, Martinez-De Jesus FR, Harkless LB, Gawish H, et al. IDF Clinical Practice Recommendation on the Diabetic Foot - 2017: a guide for health care professio nals. Brussels: IDF, 2017. Disponible en: https://www. idf.org/e-library/guidelines/119-idf-clinical-practice-recommendations-on-diabetic-foot-2017.html. [Consulta: 14 junio 2019].
44) Martins-Mendes D, Monteiro-Soares M, Boyko EJ, Ribeiro M, Barata P, Lima J, et al. The independent contribution of diabetic foot ulcer on lower extremity amputation and mortality risk. J Diabetes Complicat 2014; 28(5): 632-8.
45) Steed DL, Edington HD, Webster MW. Recurrence rate of diabetic neurotrophic foot ulcers healed using topical application of growth factors released from platelets. Wound Repair Regen 1996; 4(2):230-3. doi: 10.1046/j.1524-475X. 1996.40210.x.
46) Margolis DJ, Kantor J, Santanna J, Strom BL, Berlin JA. Effectiveness of platelet releasate for the treatment of diabetic neuropathic foot ulcers. Diabetes Care 2001; 24(3):483-8. doi: 10.2337/diacare.24.3.483.
Publicado
2021-07-21
Cómo citar
1.
Orellano P, Torres Negreira M, Colombo A, Lamela N, Saliwonczyk D, Berro M, Sierra G, Rodríguez I, Vucovich L. Experiencia con el uso de plasma rico en plaquetas autólogo en el tratamiento de las úlceras del pie diabético. Rev. Méd. Urug. [Internet]. 21 de julio de 2021 [citado 18 de diciembre de 2024];37(3):e37302. Disponible en: https://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/738
Sección
Artículos originales
