A research project will make progress towards personalised treatment of complex skin wounds with autologous platelet-rich plasma (PRP)

One of the treatments for complex wounds (i.e. those that are difficult to treat) that is increasingly being used is therapy with platelet-rich plasma obtained from the patient's own blood (autologous PRP). This therapy, which is based on applying components of the patient's blood to the wound which are unable to reach the wound normally and naturally due to the patient's state of health, has increased healing rates for complex wounds. In recent years, researchers and professionals in the Tissue Repair and Regeneration research group (TR2Lab) at the University of Vic - Central University of Catalonia (UVic-UCC) and the Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC) and the Santa Creu University Hospital in Vic (SCUH) have scientifically proven that the use of this therapy increases the rate of wounds that heal and their speed of healing, especially in diabetic wounds. They have also found that in about 30 out of every 100 patients, this therapy does not work after several sessions of treatment. 

A large amount of data must be collected from many patients in order to obtain more information and to identify the patients who really will have a positive prognosis for healing with autologous PRP from the outset, and to be able to personalise this therapy more efficiently. The research project "Multidimensional analysis for personalised therapy with autologous platelet-rich plasma: a longitudinal observational study in patients with complex wounds" has begun with this objective in mind. The study will be carried out over the next three years, and involve a total of 180 patients with prevalent complex wounds (venous, arterial and diabetic). 

This project is being led by the principal investigator Marta Otero, the coordinator of the TR2Lab research group at UVic-UCC and the IRIS-CC, and the co-principal investigator is Mariona Espaulella, a geriatrician at the Territorial Geriatric and Palliative Care Service for the Osona and Ripollès regions. The interdisciplinary research team is made up of professionals from four faculties at UVic-UCC (the Faculty of Science, Technology and Engineering; the Faculty of Health Sciences and Welfare; the Faculty of Medicine, and the Faculty of Business and Communication Studies), the SCUH, Campdevànol Hospital, the Hospital Consortium of Vic, the Althaia Foundation, and the IRIS-CC.

Collecting the data

In order to carry out the study, patients with complex wounds from the Clinical Wound Unit (CWU) at the SCUH will be treated with PRP therapy. The Hospital has been a pioneer in the use of this treatment in the Osona region since 2011. Afterwards, the samples will be processed in the laboratories of the UVic-UCC Faculty of Science, Technology and Engineering, and the in vitro studies will be carried out. The CWU, which serves a population of more than 200,000 people, treats around 200 patients with complex wounds every year, and around 60 of these undergo treatment with autologous PRP therapy. 

The wide range of data that will be collected will include sociodemographic data, the patients' general state of health, the medication they are taking and the evolution of their wounds. The composition of the patients' PRP will also be determined using proteomic techniques, and whether their PRP fosters activity by skin cells will be studied in the laboratory. All this data will improve decisions on when is the best time to start, continue or change the therapy after a few sessions of treatment.

"The results of a preliminary study in the TR2Lab have shown that we need to increase the number of patients and the data collected from each patient, if the number of patients is limited, to obtain conclusive results. There are no studies that analyse the relationship between the composition of PRP and the patients' clinical profile, or how decisive the variables within these profiles are in the success of the therapy. With this analysis, we could make progress towards a personalised and more efficient prescription of autologous PRP therapy," explains Marta Otero, the principal investigator of the project. She says that "the results will be very useful, as a significant percentage of patients with complex wounds are vulnerable patients (frail elderly people). Extracting blood from these patients in order to apply this autologous therapy must be backed by solid prognostic evidence."

Based on the systematisation of this observational study and the anticipated results, the research team aims to develop a therapeutic algorithm that helps healthcare personnel to make clinical decisions to begin, continue or stop the use of autologous PRP. A guide to clinical practice for the appropriate preparation and use of autologous PRP in complex wounds will also be produced. The aim is to contribute to rolling out the more effective use of this therapy for vulnerable patients. 

The project, which has a total budget of 152,500 Euros, has received funding from Spain's Carlos III Health Institute, which will be managed by the IRIS-CC.