الفهرس 
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Abstract
Diabetic foot ulcers (DFU) are a common, highly morbid consequence of long standing and poorly managed diabetes. Of the estimated 537 million people world wide who have diabetes19% to 34% will develop a DFU in their lifetime.
(DFU) are one of the most frequent and difficult complications in diabetes. The risk for a diabetic patient to develop an ulcer during his life is 25%. Ulcers are a frequent cause of lower limbs amputation and 84% of lower limb amputations are preceded by ulcers.
(DU) is not only a serious clinical problem with negative impacts on both the life quality and survival time, but also an economic burden with significant contribution to high cost and lengthy hospitalizations. Furthermore, the non-healing diabetic cutaneous ulcers along with the subsequent amputations may bring about costly to treat and painful disabilities. However, healing of the DU may be improved and most of the amputations may be prevented by more effective treatments based on diabetic education.
Despite treatment, many chronic ulcers fail to heal or persist for months, years and or recur after healing, requiring additional advanced wound care therapies for adequate healing.
The use of PRP, which is rich in growth factors and cytokines that may enhance the natural wound healing process, is gaining popularity.
The use of (PRP) to enhance wound healing has increased dramatically over the last decade.
The use of (PRP) has emerged as an adjunctive method for treating DFUs. (PRP) preparations were first described in the 1980s as plasma with a platelet count above that found normally in peripheral blood. The concentration of platelets in PRP is 2–6 folds higher than that of whole blood.
The curative properties of PRP rely on the fact that platelets are a physiological reservoir of a variety of growth factors, with healing function which have an active role in tissue regeneration.
Platelets contain proteins, known as growth factors that trigger biological effects including directed cell migration (i.e. chemotaxis), angiogenesis, cell proliferation and differentiation, which are key elements in the process of tissue repair and regeneration.
Platelets exert antimicrobial activity against some bacteria of the skin, and clinical data shows that the presence of infection is reduced in PRP-treated wounds.
The current study was conducted at Assiut university Hospitals. Its aimed to evaluate effect of using of (PRP) in healing diabetic foot ulcers (DFUs) and to compare the rate of healing and final outcome with similar patients on conventional therapy.
The study enrolled 92 diabetic patients with chronic non-healing DFU.
Those patients were randomly subdivided into two groups; either treated with PRP (PRP group=46 patients) or treated with conventional therapy (control group= 46 patients).
All participants were subjected to through history evaluation and complete physical evaluation. Baseline laboratory data beside HbA1c and lipid profile Those patients were followed up to three months during application of PRP dressing.
It was found that both groups had insignificant differences as regard baseline data, both groups had insignificant differences as regard different comorbidities.
In this study was found that both groups had insignificant differences as regard different characteristics of the DFU (site, size and depth of the ulcer) .
Percentage of wound reduction in the size of the ulcer at the end of the study in comparison to baseline size was significantly better in the study group (PRP group) .
Mean time to complete healing was significantly lower among PRP group in comparison to the control group.
The primary end point of the study was the percent reduction in the ulcer size including the length and width of the ulcer at the end point of the study (12weeks).
Secondary outcomes included status of the wound healing at 12 weeks of follow-up classified as complete, partial, or unhealed, the size of the ulcer at the end of treatment, and the time to maximal wound healing in weeks in both groups (time point after which no further reduction in the wound size was clinically observed).
The use of autologous PRP in our study resulted in significantly higher complete-healed diabetic foot ulcers compared with control.