Vivostat®prf® for the treatment of hard to heal chronic ulcers

Vivostat®PRF® for the treatment of hard to heal
ischemic diabetic ulcer.
Pascal Steenvoorde MD MSc*1,2, Louk P. van Doorn MA2, Jacques Oskam MD Phd1,2 From the department of Surgery1 Rijnland Hospital Leiderdorp and the Rijnland Wound We have asked the patient for permission to use this material. The patient agreed.
However publication rights are with the authors; therefore before use of this material,
approval must be given by the authors.
P. Steenvoorde, MD MSc. Rijnland Hospital Leiderdorp, Simon Smitweg 1. Postbus 2300 RC Leiderdorp, The Netherlands. Phone: 0031-715828282. Email: This is a 42-year old diabetic patient with a below knee-amputation of the other leg. She has a non-healing ulcer, for which a fore-foot amputation was perfomed. Despite several treatment strategies including: maggot debridement therapy, vacuum assisted closure therapy, surgical necrotectomies, prolonged broad-spectrum antibiotic therapy, flammazine®, alginate dressing and hyperbaric oxygen therapy. The patient has open wounds on the affected leg for 16 months, the fore-foot amputation was performed two months earlier. At the same time the patient presented with a decubital ulcer of the below-knee amputation due to malfitting of the prothesis, with wich the patient is fully ambulated. The vivostat applications were all performed in the outpatient department. The withdrawal of the blood, the cleaning of the wound and the application and subsequent dressing takes, on average, 90 minutes. The patients uses ascal® and plavix®. The first application was done after debridement, leading to local bleeding. Subsequent debridements were not performed when vivostat was applicated. After 2 applications the wound on the below knee amputation is closed and the other is after 6 applications almost closed. (now three months after starting with the treatment and one week after the 6th application). This hard to heal ulcer, started with an infection of the second toe. Necrosis progressed and eventually dig I-IV were amputated. After a fore-footampuation was performed, we found the wound-edges were not coming together and especially the dorsal part was not attached to the wound. The vivostat® is applied using the vivostat®spraypen®. The application is done in the outpatient department. From left to right (P. Steenvoorde (resident surgeon), J. Oskam (vascular surgeon) and L. van Doorn (nurse-practioner) This is after one application; the wound is healing. After application of about 1.5 ml. The material is subsequently covered with Meptihel® and left in place for 5-7 days. The material is applied using the Vivostat®spraypen® The wound is nicely healing, with wound edges reaching each other in the middle.



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