الفهرس 
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Abstract
Prevalence of DM is increasing rapidly nowadays with diabetic foot ulcer, one of the main complications of DM causing hospitalization and may ends with lower limb amputation. chronicity of diabetic foot ulcer refers to interruption of delivering important materials required for wound healing like; oxygen, nutrients and growth factors. This is due to changes occur in vessels and microenvironments related to DM. Local application of platelet-rich plasma, with concentrated growth factors, has an efficient role in DFU healing. Growth factors mainly PDGF induce cell proliferation and differentiation resulting into new tissue formation. The aim of this study is to determine efficacy of application of autologous PRP gel in patients with diabetic foot ulcers. This study was carried out on 30 patients suffering from chronic lower limb ulcers divided into: group I: 15 patients with diabetic foot ulcers. group II: 15 patients with varicose vein ulcers. There were 20 male and 10 female patients. Their age ranged from 18 to 65 years with average 45 years. Patients were treated by 3 applications of PRP gel, once every two weeks, with three follow up visits, once every two weeks from each application time, over which there was significant reduction in surface area of ulcers.
The results of the present study revealed the following:
Among all cases, (28\30) 93.3% of patients improved with
significant variable degrees of reduction in surface area (63.3±35.4%)
over follow up visits (P=0.001) and 33.3% of them achieved complete
reduction in surface area (final surface area =0 cm2). Regarding group I,
it was 64.2±35.2 % with 40% of patients showed complete reduction in
surface area. Regarding group II, healing rate percent was 62.0±36.8 %
and 26.7% of patients showed complete reduction in surface area.
Duration of disease (diabetes or varicose vein) showed significant
negative correlation with healing rate percent (p <0.001, r= -0.858) and
(p= 0.002, r= -0.740) respectively.
Regarding glycemic control, HbA1c % and the random blood
glucose for the three visits of follow up showed significant negative
correlation with healing rate percent (p= 0.006, p=0.001) respectively. As
well as patients with complete hea healing showed significant lower
concentration of both values than whom with incomplete healing
(p<0.001) for both.
There was significant increase in PDGF concentration after
activation for all cases (P<0.001). There was significant positive
correlation between healing rate percent and both, platelets count in PRP
and PDGF concentration after activation (p=0.004),(p=0.003)
respectively.
Patients with complete healing had higher significant PRP count
and PDGF concentration after activation than those with incomplete
healing (P=0.04), (P=0. 03) respectively.