Use of platelet concentrate gel in second-intention wound healing: a case report

Background: Wound healing is a complex and dynamic process. Healing of acute and chronic wounds can be impaired by patient factors (that is, comorbidities) and/or wound factors (that is, infection). Regenerative medicine products, such as autologous/homologous platelet-rich plasma gel, may speed up the healing process. Autologous/homologous platelet-rich plasma is an advanced wound therapy used for hard-to-heal acute and chronic wounds. The cytokines and growth factors contained in platelet-rich plasma play a crucial role in the healing process. Case presentation: A 61-year-old Caucasian male patient, suffering from mental retardation following meningitis, with a transplanted kidney due to prior renal impairment, and under immunosuppressant therapy, was submitted to aneurysmectomy of his proximal left forearm arteriovenous fistula. A few days later, the patient came to our attention with substantial blood loss from the surgical site. The wound presented no signs of healing, and after fistula reparation and considering persistent infection of the surgical site (by methicillin-resistant Staphylococcus aureus), surgeons decided for second-intention healing. To favor healing, 10 mL homologous platelet concentrate gel was sequentially applied. After each application, wound was covered with nonadherent antiseptic dressing. After only seven applications of homologous platelet concentrate gel, wound completely recovered and no amputation was necessary. Conclusions: Topical application of homologous platelet-rich plasma gel in healing wound shows beneficial results in wound size reduction and induces granulation tissue formation. Platelet-rich plasma could be a safe and cost-effective treatment for managing the cutaneous wound healing process to shorten the recovery period and thereby improve patient quality of life.