Study on evaluation of safety and efficacy of leucocyte platelet rich fibrin (l-prf) versus conventional dressing for the treatment of chronic cutaneous ulcers

Abstract

Introduction: Chronic cutaneous ulcers represent a significant healthcare challenge, affecting approximately 1-2% of the global population and contributing substantially to morbidity and healthcare costs. Conventional wound management strategies often yield suboptimal outcomes, necessitating the exploration of advanced therapeutic approaches. Leucocyte-Platelet Rich Fibrin (L-PRF), an autologous blood-derived biomaterial rich in platelets, leukocytes, and growth factors embedded within a fibrin matrix, has emerged as a promising regenerative medicine strategy for tissue repair. This study aimed to evaluate the efficacy and safety of L-PRF compared to conventional dressings in the management of chronic cutaneous ulcers. Methods: This prospective, randomized controlled trial enrolled 112 patients with chronic cutaneous ulcers of various etiologies, who were randomly allocated to receive either L-PRF (n=56) or conventional dressings (n=56). L-PRF was prepared from autologous blood and applied weekly to the ulcer bed in the intervention group, while the control group received standard saline-soaked gauze dressings. Outcome measures included ulcer size reduction, granulation tissue quality, pain scores, healing rates, time to complete healing, and adverse events, assessed over a 4-week follow-up period. Results: Demographic characteristics and baseline ulcer parameters were comparable between groups. The L-PRF group demonstrated significantly greater ulcer size reduction at 2 weeks (p=0.02) and 4 weeks (p<0.001), superior granulation tissue quality (p<0.001), and lower pain scores (p<0.001) compared to the conventional dressing group. Most notably, 100% of ulcers in the L-PRF group achieved complete healing versus 26.8% in the conventional group (p<0.001), with a significantly shorter healing time (4.25±0.83 vs. 5.4±0.5 weeks, p<0.001). The L-PRF group exhibited a lower incidence of minor infections (5.4% vs. 12.5%), although this difference was not statistically significant (p=0.18). No serious adverse events were reported in either group. Conclusion: L-PRF represents a highly effective regenerative medicine strategy for the treatment of cutaneous ulcers, significantly outperforming conventional dressings in terms of healing rates, healing time, tissue quality, and patient comfort. The autologous nature, minimal preparation requirements, and favorable safety profile of L-PRF enhance its clinical utility and potential for widespread implementation in chronic wound management.