Comparative Efficacy of Platelet‐Rich Plasma, Platelet‐Rich Fibrin, and Conventional Therapy in Chronic Non‐Healing Skin Ulcers: A Randomised Clinical Trial

Chronic non-healing skin ulcers are one of the most important clinical challenges, usually refusing conventional treatments. The applications of autologous platelet concentrates include platelet-rich plasma and platelet-rich fibrin, which enhance healing properties by accelerating wound healing by growth factor release. This randomised, prospective clinical trial included 36 patients aged between 18 and 65 years suffering from chronic non-healing ulcers. They were then randomly allocated into three treatment groups: Group A (PRP), Group B (PRF) and Group C (Conventional treatment). PRP and PRF were acquired by standardising blood collection from the autologous blood samples, after which they were subjected to centrifugation and applied weekly for eight sessions. Ulcer area reduction, healing rates as well as pain scores were assessed at baseline, 4 weeks and 8 weeks after baseline using ImageJ software and the Visual Analogue Scale (VAS). PRF more evidently repaired ulcers than PRP, with a mean reduction in surface area of 81.4% at 8 weeks, compared with 47.6% in PRP and 26.1% in controls (p < 0.001). Complete healing was noted among 58.3% in PRF, 41.7% in PRP and 0% in controls. Pain scores among the different groups had no significant differences, and no adverse events were noted during the study. PRF was superior to PRP and conventional therapy in healing chronic diabetic and venous ulcers, which can be attributed to its longer duration of growth factor release with a fibrin scaffold. PRF is a low-cost, autologous and accessible regenerative alternative in the management of chronic wounds.