PRF Dressing Change Frequency for Trophic Ulcers
For trophic ulcers treated with Platelet-Rich Fibrin (PRF) therapy, change the dressing weekly until complete re-epithelialization occurs or for a maximum of 6 weeks. 1, 2, 3, 4
Standard Protocol for PRF Therapy
Weekly Application Schedule
- Apply PRF and change dressings every 7 days as the standard interval for trophic ulcer treatment 1, 2, 3, 4
- Continue weekly applications until complete healing is achieved or up to a maximum of 6 sittings (6 weeks), whichever occurs first 1, 2, 4
- The mean healing time with weekly PRF application is approximately 4-5 weeks for most trophic ulcers 1, 2
Application Technique at Each Weekly Session
- Perform wound bed preparation before each PRF application 1, 3
- Apply activated PRF by spraying over the ulcer or inject intra- and perilesionally 1, 3
- Apply platelet-poor plasma gel over the ulcer bed 3
- Cover with occlusive dressings 1, 3
Mandatory Early Dressing Changes
Change the dressing immediately if any of the following occur, regardless of the weekly schedule:
- The dressing becomes damp, loosened, or soiled 5, 6, 7
- Signs of infection appear (increased pain, erythema, purulent drainage, fever) 5, 6, 7
- Visible bleeding or drainage saturates the dressing 6, 7
Expected Healing Timeline
Healing Outcomes with Weekly Changes
- 92% of patients achieve complete healing with weekly PRF applications 1
- 88% achieve complete healing by the fourth sitting (4 weeks) 1
- 90% reduction in mean ulcer volume occurs by 6 weeks with weekly applications 2
- A randomized controlled trial demonstrated 91% ulcer surface area reduction with PRF applied every 2 weeks over 8 weeks 3
Factors Affecting Healing
- Complete healing is more likely with smaller initial ulcer surface area 3
- Paucibacillary leprosy patients heal more completely than multibacillary patients 3
- Healing has no direct correlation with ulcer site, duration, or associated motor deformities 1
Important Clinical Caveats
Why Weekly Changes Are Optimal
- PRF releases growth factors that promote granulation tissue formation and rapid healing 1, 8
- Weekly application provides consistent delivery of platelet-derived growth factors directly to the wound bed 1
- More frequent changes (e.g., every 2-3 days) are unnecessary for PRF therapy and differ from standard gauze dressing protocols 5, 6
Avoid Common Pitfalls
- Do not use occlusive dressings that promote excessive moisture, as this can lead to skin maceration 5, 7
- Ensure proper wound bed preparation at each weekly session with 0.9% sodium chloride solution or sterile water 5, 7
- Completely dry the wound area after cleansing to prevent maceration of surrounding tissue 5
- Maintain aseptic technique during each PRF application and dressing change 6, 7
Evidence Quality
- The weekly dressing change protocol is supported by multiple prospective studies and one randomized controlled trial specifically evaluating PRF for trophic ulcers 1, 2, 3, 4
- A 2022 meta-analysis confirmed that PRF significantly increases the number of ulcers completely healed compared to standard wound care 8