The effect of autologous platelet rich plasma in the treatment of diabetic foot osteomyelitis patients.

PURPOSE: Diabetic foot osteomyelitis (DFO) presents substantial therapeutic challenges due to refractory healing and high recurrence rates. While platelet-rich plasma (PRP) demonstrates wound-healing potential, its efficacy in DFO management requires further exploring. This study aimed to evaluate the clinical efficacy of PRP in DFO management.

METHODS

This is a retrospective cohort study compared surgical outcomes between DFO patients receiving conventional therapy (n = 63) vs. PRP-augmented treatment (n = 68) during January 2020 and January 2025. Primary endpoints included wound healing rates (quantified at 7, 14, 30, and 90 days) and hospitalization parameters including duration of hospitalization, treatment costs, and microbial profiles. Secondary analysis evaluated Wagner grade 4 subpopulations. Baseline characteristics were analyzed using descriptive statistics. The wound healing rate at each time points between PRP and control group was compared by the analysis of covariance

RESULTS

PRP administration resulted in a significantly higher 7-day wound closure rate compared to the control group (88.10% ± 10.37% vs. 83.51% ± 10.85%, p = 0.015). In patients with Wagner grade 3, the PRP group exhibited a significantly greater healing rate at 7 days (98.64% ± 2.40% vs. 94.95% ± 5.19%, p = 0.018) while no statistical difference was found at other time points (14 days: 99.71% ± 0.73% vs. 98.86% ± 2.24%, p = 0.193; 30 days 99.83% ± 0.58% vs. 98.00% ± 7.28%, p = 0.386; 90 days 99.67% ± 1.15% vs. 99.36% ± 1.89%, p = 0.626). Moreover, among those with Wagner grade 4, the PRP group demonstrated consistently superior healing outcomes across all time points (7 days: 89.94% ± 8.35% vs. 78.33% ± 12.20%, p = 0.006; 90 days: 99.93% ± 0.37% vs. 98.33% ± 4.08%, p = 0.008). Treatment with PRP was also associated with a 13.3% reduction in the mean hospitalization duration ((28.47 ± 10.43) days vs. (32.85 ± 11.50) days, p = 0.029), despite incurring higher treatment costs ($6740.44 ± $3048.42 vs. $5370.97 ± $3600.43, p = 0.025). No adverse events related to PRP application were observed.

CONCLUSIONS

The present study demonstrates that PRP significantly accelerated the wound healing process in DFO patients, especially in Wagner grade 3 and 4 cases. Despite the associated increase in cost, PRP treatment led to a marked reduction in hospital stay. These findings suggest that PRP may constitute a promising therapeutic strategy for DFO management, offering improved clinical outcomes while maintaining an acceptable safety profile.