Efficacy of platelet-rich concentrates in healing chronic ulcers of distinct etiologies: a focus on diabetic neuropathic and venous ulcers

Background: Platelet-rich concentrates have emerged as adjuncts in chronic wound management, with healing potential influenced by underlying etiology. Objective: To evaluate whether ulcer etiology (diabetic neuropathic vs. venous ulcers) influences healing outcomes following treatment with platelet-rich concentrates (platelet-rich plasma and platelet-rich fibrin) in chronic nonhealing ulcers, using secondary analysis of a randomized clinical trial. Patients and methods: In this prospective stratified randomized controlled study, 36 patients were stratified by ulcer etiology (18 diabetic foot ulcers, 18 venous leg ulcers, randomized in a 1 : 1 : 1 ratio within each stratum to receive platelet-rich plasma, platelet-rich fibrin, or conventional therapy. ImageJ was used to assess and measure the ulcer before and after the reduction in wound area over a period of 8 weeks. Results: No statistically significant differences were observed between diabetic neuropathic and venous ulcers in surface area reduction (week 4: P =0.436; week 8: P =0.246), healing rate (week 4: P =0.74; week 8: P =0.55), or time to complete healing ( P =0.5592), despite numerically greater improvements in the diabetic group. Conclusion: Healing outcomes following treatment with platelet-rich concentrates were comparable between diabetic neuropathic and venous ulcers. Although diabetic ulcers showed numerically greater improvement in some parameters, and venous ulcers had a higher complete-healing rate, these differences were not statistically significant. While baseline demographic differences between groups may have influenced healing patterns, they did not result in statistically significant differences in overall outcomes.