Physiological-concentration Platelet Fibrin Plasma vs. Supra-Physiological-concentration Platelet Rich Plasma for Neuro-ischemic Diabetic Foot Ulcer and other Diabetic Wounds: A Randomized Controlled Trial

Why clinicians should know about it

• Picked for Dermatology (top studies of the week, 19 July 2026): Platelet products for diabetic foot ulcers, wound care not dermatology

Abstract

BACKGROUND: Although platelet concentrates are associated with substantial blood consumption, whether platelet products at physiological concentrations can achieve comparable efficacy in chronic wounds remains unclear. OBJECTIVE: To determine if physiological concentration platelet fibrin plasma (PFP) is non-inferior to supra-physiological platelet-rich plasma (PRP) for diabetic wound healing. METHODS: This single-center, non-inferior randomized controlled trial enrolled patients with diabetic wounds who, after wound-bed-preparation with corrected infection, ischemia, stasis, shear forces, were scheduled for debridement suture surgery (DSS). Participants received either PFP (1× baseline) or PRP (4× baseline) during DSS. The primary outcome was the 4-week healing rate. Subgroup analysis was based on ulcer location. RESULTS: 56 patients were enrolled (DFU: 66%, all neuro-ischemic type; other sites: 34%), groups were balanced (DFU: 65.5% vs 64.3%, P=0.922;). Non-inferiority was confirmed: 4-week healing was 78.6% (PFP) vs 71.4% (PRP) (one-sided 95% CI lower bound -12.4%, P=0.038). No significant differences emerged in 2-, 3-, 6-, and 8-week healing rates, mean healing time (30.1 vs 32.2 days) (all P>0.05). LIMITATIONS: Single center with a relatively small sample size. CONCLUSION: Physiological PFP demonstrated similar efficacy to supra-physiological PRP. With simpler preparation and lower blood consumption, PFP offers a practical, equivalent alternative.

Abstract as published, via PubMed.