Treatment with platelet-rich plasma (PRP) consists of extracting a small amount of blood from the patient himself, which is later processed by centrifugation to obtain a fraction rich in platelets. It will be done on weekly or fortnightly blood extraction procedure, depending on the process. Between 1-3 sterile citrate collection tubes will be used, which may vary depending on the size of the ulcer. Each tube can contain approximately 8-10ml of blood and the procedure is carried out under aseptic conditions and with material from a single use Once the sample has been centrifuged, the blood plasma will be extracted and the concentrate obtained will be applied directly on the wound or ulcer with the objective of stimulating and accelerating healing by means of growth factors.

This procedure is used as complementary therapy in chronic ulcers or with difficulty in healing, such as they can be venous, arterial, pressure or diabetic foot ulcers.

1. Introduction

   Platelet-rich plasma (PRP) is an autologous blood derivative obtained by centrifuging the patient's own blood. It contains a high concentration of growth factors that promote tissue regeneration and cell proliferation. Its use in the treatment of chronic ulcers has shown good results, especially in wounds that do not respond to conventional treatments.

2. Required Materials

   Sterile 5 ml and 10 ml syringes

   Needles or butterfly needle and 20G vacutainer for extraction, and 30G (4 mm or 13 mm) for infiltration

   Tube with anticoagulant (3.8% sodium citrate), closed system technique

   Clinical centrifuge with fixed-angle or swinging-bucket rotor

   Gloves, mask, gown, and sterile working surface

   Sterile dressings, saline solution, and antiseptics

3. Blood Extraction

   Draw between 10 and 20 ml of venous blood from the patient, depending on the extent of the ulcer. Use tubes with anticoagulant to prevent premature coagulation.

   Apply a closed system technique to avoid handling and contamination of the sample.

4. Centrifugation

   Use a single centrifugation cycle to obtain high-quality PRP: 3500 rpm for 10 minutes.

   Once the process is complete, prepare the PRP in the selected 5 ml or 10 ml syringes.

5. PRP Application

   → Before application:

   Clean the wound with saline solution and antiseptic.

   Perform debridement if there is necrotic or fibrinous tissue.

   → Application methods:

   Intradermal or subdermal perilesional infiltration using a fine needle (30G 4 mm or 30G 13 mm).

   Direct application of PRP onto the wound bed.

   Apply a topical layer.

   Cover with a sterile dressing or gauze soaked in the same PRP.

6. Monitoring and Follow-Up

   Evaluate the wound weekly or biweekly.

   Repeat treatment every 1-2 weeks depending on progress.

   Take photographs and document each visit to assess clinical response.

7. Contraindications and Precautions

   Severe thrombocytopenia (< 100,000 platelets/μL)

   Active systemic infection

   Severe hematological disorders

   Do not administer in case of allergy to the anticoagulants used

   Active local infection

8. Conclusions

PRP represents an innovative and safe therapeutic option in the management of chronic ulcers, with good clinical outcomes and minimal side effects when performed using the appropriate technique.

Inclusion Criteria:

• Patients with Grade III ulcers.
• Patients with ulcers older than two weeks.
• Patients with an optimal platelet count according to prior laboratory tests.

Exclusion Criteria:

• Patients with a palliative profile.
• Patients with a limited life expectancy.
• Patients with a platelet count below 10 × 10⁹/L

All patient data will be stored in the REDCAP system, which ensures the protection of patients' personal data.

he data will be accessible only to the principal investigators of the study, from the start of the study (November 2025) until the completion of the data analysis (February 2028)

Only the principal investigators of the study will have access to the data, and the data can only be accessed through the REDCAP application