[Study on the mechanism of autologous platelet-rich gel to treat the refractory diabetic dermal ulcers].

Objective: To investigate the mechanism of autologous platelet-rich gel (APG)in the treatment of refractory diabetic dermal ulcers.

Methods: After the treatment of refractory diabetic dermal ulcers with APG at 0, 3, 6, 9, 15 days, the protein levels of PDGF-BB, VEGF, IGF-1, EGF and TGF-beta1 in the granulation tissue were detected by ELISA, while the dimensions of ulcer area were measured at the same time.

Results: The areas of ulcers were obviously reduced at the third and fifteen day after APG treatment (P < 0.05). The concentrations of these 5 growth factors in the granulation tissue were began to increase after 3 days treatment, the peak of PDGF-BB emerged at the third day (P < 0.05), and the peaks of VEGF, IGF-1, TGF-beta1 were found at the ninth day (P < 0.05). The concentration of VEGF increased 2.1-fold, IGF-1 increased 1.95-fold, EGF increased 1.75-fold, PDGF-BB increased 1.89-fold and TGF-beta1 increased 1.67-fold.

Conclusion: The expression of multiple growth factors are increased in granulation tissue of refractory diabetic dermal ulcers after the treatment of APG,which might be one of the mechanism of APG to treat refractory diabetic dermal ulcer.