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Open AccessFeature PaperCase Report
Diseases 2018, 6(2), 30; https://doi.org/10.3390/diseases6020030

Use of Leukocyte Platelet (L-PRF) Rich Fibrin in Diabetic Foot Ulcer with Osteomyelitis (Three Clinical Cases Report)

1
Unit of Dermosurgery Cutaneous Transplantations and Hard-to-Heal Wound, “Villa Fiorita” Private Hospital, 81031 Aversa, CE, Italy
2
School of Medicine, University of Salerno Italy, 84084 Fisciano, SA, Italy
3
Institute for the Studies and Care of Diabetics, Abetaia, 81020 Casagiove, CE, Italy
4
Pathological Anatomy, “Pineta Grande” Private Hospital, 81030 Castelvolturno, CE, Italy
5
Faculty of Medicine and Surgery, Vasile Goldis Western University of Arad, 310025 Arad, Romania
*
Author to whom correspondence should be addressed.
Received: 21 March 2018 / Revised: 18 April 2018 / Accepted: 21 April 2018 / Published: 24 April 2018
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Abstract

In this study, the use of fibrin rich in leukocytes and platelets (L-PRF) was explored to heal osteomyelitis ulcers in a diabetic foot. The goal was to standardize the utilization of L-PRF in patients with osteomyelitis to direct it for healing. L-PRF was obtained autologously from the peripheral blood of the diabetic patients (n = 3) having osteomyelitis and skin lesions for at least six months. The L-PRF and supernatant serum were inserted into the skin lesion to the bone after a surgical debridement. The evolution of lesions over time was analyzed. All three patients showed positivity to the Probe-to-Bone test and Nuclear Magnetic Resonance detected cortico-periosteal thickening and/or outbreaks of spongy cortical osteolysis in adjacency of the ulcer. The infections were caused by Cocci Gram-positive bacteria, such as S. Aureus, S. β-hemolytic, S. Viridans and Bacilli; and Gram-negative such as Pseudomonas, Proteus, Enterobacter; and yeast, Candida. The blood count did not show any significant alterations. To date, all three patients have healed skin lesions (in a patient for about two years) with no evidence of infection. These preliminary results showed that L-PRF membranes could be a new method of therapy in such problematic diseases. Overall, the L-PRF treatment in osteomyelitis of a diabetic foot seems to be easy and cost-effective by regenerative therapy of chronic skin lesions. In addition, it will improve our understanding of wound healing. View Full-Text
Keywords: osteomyelitis; buffy coat; growth factor level; platelet-rich fibrin; thrombocyte concentrate osteomyelitis; buffy coat; growth factor level; platelet-rich fibrin; thrombocyte concentrate
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Crisci, A.; Marotta, G.; Licito, A.; Serra, E.; Benincasa, G.; Crisci, M. Use of Leukocyte Platelet (L-PRF) Rich Fibrin in Diabetic Foot Ulcer with Osteomyelitis (Three Clinical Cases Report). Diseases 2018, 6, 30.

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