The Effect of Platelet Rich Plasma on Wound Healing in Pressure Ulcer Patient Grade III and IV

Abstract

Pressure injury is soft tissue damage caused by persistent mechanical pressure on bony prominences, with incidence rates continuing to rise. To address this issue, platelet-rich plasma (PRP) is being researched and developed. This study aims to compare the effects of injectable and topical PRP administration on pressure injury healing, using the Pressure Ulcer Scale for Healing (PUSH) score and collagen density as measures. This experimental study was conducted with grade III and IV pressure injury patients treated at a tertiary referral hospital in Bandung. The subjects were divided into three groups: control, PRP injection and topical PRP. Wound treatment and observation were conducted over 21 days, with evaluations based on the PUSH score (wound area, exudate amount and tissue type) and collagen density. This study involved 22 patients with 30 pressure ulcers. Significant differences were observed in the mean Δ PUSH score (p = 0.047) and mean Δ collagen density (p = 0.011) in the PRP injection group compared to the control group. No significant differences were found between the PRP injection and topical PRP groups regarding PUSH score (p = 0.162) and collagen density (p = 0.862). In the PRP injection group, a significant decrease in the PUSH score was observed on day 12 (p = 0.045), whilst in the topical PRP group, a significant decrease occurred on day 21 (p = 0.034). PRP injection significantly reduces PUSH scores and increases collagen density compared to the control group. By day 21, no significant differences were observed between PRP injection and topical PRP. However, PRP injection demonstrated faster clinical improvement, with significant changes in PUSH score evident by day 12, compared to day 21 for topical PRP.