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PLASMA RICO EN PLAQUETAS AUTOLOGO TOPICO PARA EL TRATAMIENTO DE LA ULCERA DE PIE DIABETICO

(especial para SIIC © Derechos reservados)
La úlcera de pie diabético constituye una de las complicaciones frecuentes de la diabetes. Del 15% al 25% de los pacientes presentan úlceras en algún momento de su vida. Se valoró la evidencia existente sobre la eficacia del plasma rico en plaquetas autólogo tópico para el tratamiento de úlcera de pie diabético. Se necesitan estudios de calidad metodológica, mayor producción de ensayos clínicos en Latinoamérica y valoración de calidad de vida y dolor.
Autor:
Sebastián Brescia
Columnista Experto de SIIC

Institución:
Hospital Eduardo Canosa


Artículos publicados por Sebastián Brescia
Coautores
Ronald Ramos* Guillermo Nicolás Jemar** Adolfo Ruíz*** 
Médico, Hospital Eduardo Canosa, Puerto Santa Cruz, Argentina*
Médico especialista en Neuropsiquiatría, Hospital Psicoasistencial Dr. José T. Borda, Ciudad de Buenos Aires, Argentina**
Médico cirujano, Hospital Córdoba, Córdoba, Argentina***

Resumen
Antecedentes: La úlcera de pie diabético constituye una de las complicaciones frecuentes de la diabetes. Del 15% al 25% de los pacientes presentan úlceras en algún momento de su vida. Se valoró la evidencia existente sobre la eficacia del plasma rico en plaquetas (PRP) autólogo tópico para el tratamiento de úlcera de pie diabético. Método: Se llevó a cabo a partir de datos de Pubmed, Cochrane, Lilacs y Clinical Trials, búsqueda de ensayos clínicos aleatorizados controlados que compararon PRP autólogo tópico frente a cuidados estándar y placebo. Para los resultados dicotómicos se usó el análisis de riesgo relativo, con intervalos de confianza del 95% y el método de Mantel-Haenszel; para los resultados continuos, se calculó la diferencia de medias y método de varianza inversa. Resultados: El resultado de la búsqueda fue 153 estudios, se excluyeron 28 duplicados, 59 por título y abstract y 52 por lectura de artículo. Se incluyeron 14 trabajos en la revisión, 8 para revisión cualitativa y 6 para cuantitativa. Se valoraron 6 estudios con desenlace de curación completa de úlcera al final de la intervención, sobre un total de 415 participantes (riesgo relativo 1.24 [IC 95%: 1.11 a 1.40]). No se informó el desenlace área epitelizada al final de la intervención medida en cm². Un solo estudio midió calidad de vida y dolor. Conclusión: Existe evidencia del efecto beneficioso del PRP autólogo tópico para la curación de úlcera de pie diabético; no obstante, se necesitan estudios de mayor calidad metodológica, mayor producción de ensayos clínicos en Latinoamérica y valoración de calidad de vida y dolor.

Palabras clave
plasma rico en plaquetas autólogo, diabetes, úlcera de pie diabético, plasma rico en plaquetas gel, calidad de vida


Artículo completo

(castellano)
Extensión:  +/-7.45 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

Abstract
Background: Diabetic foot ulcer is one of the frequent complications of diabetes. 15% to 25% develop ulcers at some point in their lives. The existing evidence on the efficacy of topical autologous platelet-rich plasma (PRP) for the treatment of diabetic foot ulcers was assessed. Method: A search for randomized controlled clinical trials comparing autologous topical PRP vs standard care and placebo was carried out in Pubmed, Cochrane, Lilacs, and Clinical Trials databases. For dichotomous outcomes, relative risk analysis, 95% CI, and the Mantel-Haenszel method were used; for continuous outcomes, the mean difference and inverse variance method were calculated. Results: The result of the search was 153 studies, 28 duplicates were excluded, 59 by title and abstract, and 52 by reading the article. 14 studies were included in the review, 8 for qualitative review and 6 for quantitative. Six studies with a complete ulcer-healing outcome at the end of the intervention were evaluated, out of a total of 415 participants (relative risk 1.24 CI [1.11, 1.40]). The outcome epithelialized area at the end of the intervention, measured in cm², was not reported. A single study measured quality of life and pain. Conclusion: There is evidence of the beneficial effect of topical autologous PRP for the healing of diabetic foot ulcers, however, studies of higher methodological quality, greater production of clinical trials in Latin America, and assessment of the quality of life and pain are needed.

Key words
autologous platelet rich plasma, diabetic foot ulcer, gel platelet rich plasma, quality of life, diabetes


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Diabetología, Medicina Interna
Relacionadas: Endocrinología y Metabolismo, Ortopedia y Traumatología



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Bibliografía del artículo
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