Platelet rich plasma for diabetic and leprosy related foot ulcers treatment in low-resource settings: An extended approach to investigate wound healing mechanisms

Summary: Abstract Body: Background:Diabetic and leprosy foot-ulcers remain major contributors to morbidity,disability and amputation, imposing a heavy economic burden on healthcare systems.Diabetic-ulcers affect 15-25% of patients globally, while Nepal continues to grapple with endemic leprosy, reporting annual prevalence of 11.8 per 100,000 in 2023,with 6% of cases presenting severe deformities and ulcers. Neuropathic-ulcers associated with leprosy are particularly resistant to conventional therapies.Platelet-Rich Plasma, abundant in growth-factors has shown promise in enhancing wound-healing. Methods:A study was conducted with chronic foot ulcers(16 diabetic,16 leprosy-related two groups). PRP therapy and conventional treatment. Wound healing was assessed using the Bates-Jensen Wound Assessment Tool, dermoscopy and vascular USG before and after treatment. Laboratory parameters included CRP,ESR,HbA1c.USG analyzed blood flow velocity, vascularization patterns and granulation-tissue formation. Results:PRP therapy significantly accelerated healing, with complete epithelialization achieved in 36.7±3 days in the PRP group versus60.6± 3.7 days in the control group(p< 0.0001).Dermoscopy showed increased vascularization and granulation tissue in the PRP group by the second week. USG findings confirmed improved blood flow and enhanced vascularization in the periwound areas. Inflammatory markers declined more significantly in the PRP group(p< 0.01).Healing outcomes were consistent regardless of ulcer size,duration, or associated deformities in leprosy patients. Conclusion:PRP therapy demonstrates a significant reduction in healing time and enhanced vascularization, as evidenced by USG and dermoscopy. Its simplicity, safety and cost-effectiveness make it ideal for resource-limited settings.This study underscores PRP's potential as a transformative therapeutic modality for managing chronic diabetic and leprosy-related ulcers,reducing disability and healthcare-costs while improving quality of life in vulnerable populations. Shambhu D. Joshi¹, Mandeep D. Joshi² 1. Mahabaudha Medical Center, Dhangadhi, Nepal. 2. manipal college of medical sciences, Pokhara, Nepal. Stem Cell Biology, Tissue Regeneration and Wound Healing