Chronic cutaneous ulcers constitute a significant clinical challenge because of their prolonged course, high rates of recurrence, and substantial impact on patient quality of life. Unlike acute wounds, which typically progress through the physiological stages of healing in a predictable sequence, chronic ulcers remain arrested in one or more phases, leading to delayed or incomplete repair. The burden of chronic wounds is further compounded by systemic factors such as diabetes mellitus, anemia, malnutrition, and local factors including ischemia, infection, and repeated trauma. These wounds often require long-term care and impose considerable socioeconomic costs.

Conventional management strategies for chronic ulcers involve regular debridement, topical antimicrobial therapy, pressure off-loading, and, in selected cases, surgical intervention. Despite these measures, healing outcomes are frequently inconsistent and time-consuming. In recent years, attention has shifted toward biologically active therapies aimed at enhancing the intrinsic repair mechanisms of tissues.

Autologous platelet-rich plasma (PRP) has emerged as a promising adjunct in wound management. PRP is a concentrated preparation of platelets derived from the patient’s own blood and is rich in growth factors such as platelet-derived growth factor, transforming growth factor-, and vascular endothelial growth factor. These bioactive molecules play a critical role in angiogenesis, fibroblast proliferation, and extracellular matrix formation, all of which are essential for tissue regeneration. The present study was designed to evaluate the clinical effectiveness and safety of locally administered autologous PRP in patients with chronic non-healing cutaneous ulcers.

This prospective comparative study was carried out in the Department of General Surgery at Rajarajeshwari Medical College and Research Hospital, Bengaluru. Ninety patients presenting with chronic non-healing ulcers were enrolled after obtaining approval from the Institutional Ethics Committee and written informed consent from all participants. Patients were randomly allocated into two groups. The study group (n = 45) received local injections of autologous platelet-rich plasma, while the control group (n = 45) was managed using conventional wound care with 10% povidone-iodine dressings. Ulcers included Wagner’s grade I–III diabetic foot ulcers, traumatic non-healing wounds, pressure sores, venous ulcers, and other chronic cutaneous ulcers of non-specific etiology. Baseline demographic data, ulcer characteristics, relevant laboratory investigations, and wound culture reports were recorded for all patients. Wounds were followed regularly until complete epithelialization occurred or until further surgical intervention such as secondary suturing or skin grafting was required. The primary outcome measure was complete wound closure, while the secondary outcome was the duration required to achieve healing. Statistical analysis was performed using the Chi-square test, and a p-value of less than 0.05 was considered statistically significant.

Sterile cultures were observed in 62.2% of patients in the PRP group and 55.6% of patients in the control group, accounting for 58.9% of cases overall. Among culture-positive wounds, Staphylococcus aureus was the most frequently isolated organism in both groups, followed by Acinetobacter, Citrobacter, and Klebsiella species. There was no statistically significant difference in microbial growth patterns between groups (p = 0.5737). Despite similar culture profiles, the PRP-treated group demonstrated superior wound healing outcomes compared with the control group.

Table 1: Distribution of Wound Culture Results

Chronic cutaneous ulcers continue to pose a therapeutic dilemma despite advances in wound care. Standard treatment typically includes repeated debridement and the application of topical antimicrobial agents such as povidone-iodine or silver-based dressings. However, these measures often fail to address the underlying biological deficiencies that impair tissue regeneration.

Patients who received autologous PRP exhibited faster and more complete wound healing when compared with those managed by conventional dressing methods. These findings align with previously published clinical trials and systematic reviews that have highlighted the regenerative potential of PRP in chronic wound management. The beneficial effect of PRP can be attributed to its high concentration of growth factors, which enhance neovascularization, stimulate fibroblast activity, and promote the formation of healthy granulation tissue. The absence of a significant difference in wound culture results between the two groups suggests that the observed improvement in healing with PRP is primarily due to its biological reparative properties rather than an antimicrobial effect alone.

Local administration of autologous platelet-rich plasma is more effective than conventional povidone-iodine dressings in promoting faster and complete healing of chronic cutaneous ulcers. PRP facilitates the development of healthy granulation tissue and represents a safe, cost-effective, and clinically valuable adjunct in the treatment of chronic non-healing wounds.

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