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Wound Healing in Diabetic Foot Ulcer Patients Using Combined Use of Platelet Rich Fibrin and Hyaluronic Acid, Platelet Rich Fibrin and Placebo: An Open Label, Randomized Controlled Trial

ACTA MEDICA INDONESIANA · Vol. 53 No. 3 (2021)

ISSN
2338-2732, 0125-9326
Published
2021-10-04
Publisher
The Indonesian Society of Internal Medicine
Language
eng

Abstract

Background: Autologous platelet-rich fibrin (A-PRF) is an adjunctive method for diabetic foot ulcer (DFU) in addition to glycaemic control and debridement. This study aimed to evaluate the role of A-PRF + hyaluronic acid (HA), A-PRF and sodium chloride 0.9% (control) in DFU wound healing. Nowaday, the use of PRF autologous consider as adjuvant therapy in DFU treatment. Methods: This open-label randomized controlled trial was conducted at Koja District Hospital and Gatot Soebroto Hospital from July 2019 to April 2020. DFU patients with wound duration of three months, Wagner-2, and ulcer size < 40 cm2 were recruited and randomly assigned into A-PRF + AH, A-PRF and control group. On day-0, day-3 and day -7, samples and photographs were taken. Samples were analysed with ELISA and photographs were analysed with ImageJ to calculate granulation index (GI). Statistical analysis was performed using SPSS version 20. Results: Topical therapy with A-PRF + AH was associated with a significant increase in VEGF from day 0 (232.8 pg/mg) vs day 7 (544.5 pg/mg) compared to A-PRF on day 0 (185.7 pg/mg) vs day 7 (272.8 pg/mg), and the controls on day 0 (183.7 pg/mg) vs day 7 (167.4 pg/mg). On evaluation of VEGF swab, there is increasing significantly in A-PRF+HA group compare others group in day -3 ( p=0.022) and day -7 (p= 0.001).In the A-PRF + AH group, there was a significant decrease in IL-6 from day 0 (106.4 pg/mg) vs day 7 (88.7 pg/mg) compared with PRF on day 0 (91.9 pg/mg) vs day 7 (48,8 pg/mg). IL-6 was increased in the control group from day 0 (125.3 pg/mg) vs day 7 (167.9 pg/mg). On evaluation of IL-6 swab, there is decreasing significantly in A-PRF+HA group compare others group in day -7 (p= 0.041). Conclusion: The PRF + HA combination increased angiogenesis and reduced inflammation in DFUs and may represent a new DFU therapy.

Keywords

Collaboration network of the authors

40 authors · 254 co-authorship links · showing the 40 most connected

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  • University of Indonesia
  • Affiliation unknown
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Co-authorOrganisationJoint articles
Kuntjoro HarimurtiAffiliation unknown7
Hamzah ShatriAffiliation unknown7
Tri Juli Edi TariganUniversity of Indonesia4
Imam SubektiAffiliation unknown4
Eka GinanjarAffiliation unknown4
Taufik IndrajayaAffiliation unknown4
Arif MansjoerAffiliation unknown4
Siti SetiatiAffiliation unknown4
Suhendro SuwartoAffiliation unknown4
Muhammad YaminAffiliation unknown3
Cleopas Martin RumendeAffiliation unknown3
Cosphiadi IrawanAffiliation unknown3
Suzanna ImmanuelAffiliation unknown3
Dita AditianingsihAffiliation unknown3
Rudi PutrantoAffiliation unknown3
Ika P WijayaAffiliation unknown2
Ika Prasetya WijayaAffiliation unknown2
Simon SalimAffiliation unknown2
Aida LydiaAffiliation unknown2
Lisnawati LisnawatiAffiliation unknown2
Indrati SuroyoAffiliation unknown2
Suhendro SuhendroAffiliation unknown2
Sally Aman NasutionAffiliation unknown2
Lies Dina LiastutiAffiliation unknown2
Pradana SoewondoAffiliation unknown2
Maruhum Bonar H MarbunAffiliation unknown2
Dadang MakmunAffiliation unknown2
Iris RengganisAffiliation unknown2
Raden Irawati IsmailAffiliation unknown2

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
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	<dc:title xml:lang="en-US">Wound Healing in Diabetic Foot Ulcer Patients Using Combined Use of Platelet Rich Fibrin and Hyaluronic Acid, Platelet Rich Fibrin and Placebo: An Open Label, Randomized Controlled Trial</dc:title>
	<dc:creator>Kartika, Ronald Winardi</dc:creator>
	<dc:creator>Alwi, Idrus</dc:creator>
	<dc:creator>Suyatna, Franciscus D</dc:creator>
	<dc:creator>Yunir, Em</dc:creator>
	<dc:creator>Waspadji, Sarwono</dc:creator>
	<dc:creator>Immanuel, Suzana</dc:creator>
	<dc:creator>Bardosono, Saptawati</dc:creator>
	<dc:creator>Sungkar, Saleha</dc:creator>
	<dc:creator>Rachmat, Jusuf</dc:creator>
	<dc:creator>Hediyati, Mirta</dc:creator>
	<dc:creator>Silalahi, Todung</dc:creator>
	<dc:subject xml:lang="en-US">diabetic foot ulcer</dc:subject>
	<dc:subject xml:lang="en-US">platelet-rich fibrin</dc:subject>
	<dc:subject xml:lang="en-US">hyaluronic acid</dc:subject>
	<dc:subject xml:lang="en-US">endocrinology</dc:subject>
	<dc:description xml:lang="en-US">Background: Autologous platelet-rich fibrin (A-PRF) is an adjunctive method for diabetic foot ulcer (DFU) in addition to glycaemic control and debridement. This study aimed to evaluate the role of A-PRF + hyaluronic acid (HA), A-PRF and sodium chloride 0.9% (control) in DFU wound healing. Nowaday, the use of  PRF autologous consider as adjuvant therapy in DFU treatment. Methods: This open-label randomized controlled trial was conducted at Koja District Hospital and Gatot Soebroto Hospital from July 2019 to April 2020. DFU patients with wound duration of three months, Wagner-2, and ulcer size &amp;lt; 40 cm2 were recruited and randomly assigned into A-PRF + AH, A-PRF and control group. On day-0, day-3 and day -7, samples and photographs were taken. Samples were analysed with ELISA and photographs were analysed with ImageJ to calculate granulation index (GI). Statistical analysis was performed using SPSS version 20. Results: Topical therapy with A-PRF + AH was associated with a significant increase in VEGF from day 0 (232.8 pg/mg) vs day 7 (544.5 pg/mg) compared to A-PRF on day 0 (185.7 pg/mg) vs day 7 (272.8 pg/mg), and the controls on day 0 (183.7 pg/mg) vs day 7 (167.4 pg/mg). On evaluation  of VEGF swab, there is increasing significantly in A-PRF+HA group compare others group in day -3 ( p=0.022) and day -7 (p= 0.001).In the A-PRF + AH group, there was a significant decrease in IL-6 from day 0 (106.4 pg/mg) vs day 7 (88.7 pg/mg) compared with PRF on day 0 (91.9 pg/mg) vs day 7 (48,8 pg/mg). IL-6 was increased in the control group from day 0 (125.3 pg/mg) vs day 7 (167.9 pg/mg). On evaluation  of IL-6 swab, there is decreasing significantly in A-PRF+HA group compare others group in day -7 (p= 0.041). Conclusion: The PRF + HA combination increased angiogenesis and reduced inflammation in DFUs and may represent a new DFU therapy.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2021-10-04</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en-US">RCT open label</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/1601</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 53 No. 3 (2021): Acta Medica Indonesiana; 268</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/1601/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2021 Acta Medica Indonesiana</dc:rights>
</oai_dc:dc>