{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:05:34Z","timestamp":1779681934537,"version":"3.53.1"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004071","name":"Khon Kaen University","doi-asserted-by":"publisher","award":["IN65245"],"award-info":[{"award-number":["IN65245"]}],"id":[{"id":"10.13039\/501100004071","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Chronic non\u2010healing wounds represent a major global public health challenge. Their persistence is frequently attributed to localized biological deficits that cause them unresponsive to conventional therapeutic modalities. While Platelet\u2010Rich Plasma (PRP) has demonstrated promising results as an adjunctive treatment by delivering highly concentrated growth factors, its clinical application is currently impeded by a lack of clinical standardization, particularly optimal injection frequency, interval, and dosage. The aim of this study is to rigorously evaluate the efficacy and safety of a specific, non\u2010intensive two\u2010dose PRP injection protocol for accelerating the reduction of wound area in patients with various types of refractory chronic wounds. We conducted a prospective, single\u2010arm, pretest\u2010posttest study enrolling 18 patients with refractory non\u2010healing wounds, defined as lesions persisting for a minimum period of 4\u2009weeks which had failed to achieve definitive closure under optimized standard care. Autologous high\u2010concentration PRP was injected intradermally around the wound margin at baseline (Day 0) and again 3\u2009weeks later (Day 21). Wound area was digitally measured at baseline and subsequently at 7, 11 and 15\u2009weeks. The primary outcome was the mean reduction in wound area (cm\n                    <jats:sup>2<\/jats:sup>\n                    ) at the 15\u2010week follow\u2010up, assessed using a Paired Samples\n                    <jats:italic>t<\/jats:italic>\n                    \u2010test. The mean patient age was 57.89\u2009\u00b1\u200915.64\u2009years, and wounds had a mean chronicity of 15.83\u2009\u00b1\u200919.05\u2009months. The PRP preparation achieved a mean platelet concentration 8.5 times greater than the peripheral blood threshold (first injection) and 7.0 times greater than the threshold (second injection), confirming high therapeutic quality. Analysis of the total cohort demonstrated a statistically significant reduction in mean wound area from baseline 27.41\u2009\u00b1\u200970.38\u2009cm\n                    <jats:sup>2<\/jats:sup>\n                    to 15\u2009weeks 21.5\u2009\u00b1\u200968.96\u2009cm\n                    <jats:sup>2<\/jats:sup>\n                    . Three patients (16.67%) achieved complete epithelialization. Subgroup trends suggested diabetic and venous ulcers responded more favourably than radiation\u2010induced ulcers. The protocol was safe, with no systemic or severe localized adverse events observed among participants. The defined two\u2010dose PRP injection protocol provides a clinically effective and safe adjunctive therapy that significantly promotes wound area reduction in challenging chronic non\u2010healing wounds. This reproducible, low\u2010frequency protocol offers a rationale for standardization in advanced wound care, warranting validation through future large\u2010scale Randomized Controlled Trials (RCTs).\n                  <\/jats:p>","DOI":"10.1111\/iwj.70932","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T23:16:19Z","timestamp":1778022979000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of a Defined Two\u2010Dose Protocol of Autologous Platelet\u2010Rich Plasma (\n                    <scp>PRP<\/scp>\n                    ) Injection for Refractory Chronic Non\u2010Healing Wounds: A Prospective Clinical Study"],"prefix":"10.1111","volume":"23","author":[{"given":"Nathathai","family":"Wanchutrirat","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2651-5753","authenticated-orcid":false,"given":"Kamonwan","family":"Jenwitheesuk","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kriangsak","family":"Jenwitheesuk","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiyada","family":"Punjaruk","sequence":"additional","affiliation":[{"name":"Department of Physiology and Blood Bank, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palakorn","family":"Surakunprapha","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8348-5941","authenticated-orcid":false,"given":"Kengkart","family":"Winaikosol","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pattama","family":"Punyawong","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pimthawan","family":"Vachirodom","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaweesak","family":"Saothonglang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weerin","family":"Sawangkajohn","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thitinan","family":"Kasetthat","sequence":"additional","affiliation":[{"name":"Department of Physiology and Blood Bank, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524\u2010475X.2009.00543.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2016.25.5.277"},{"issue":"4","key":"e_1_2_10_4_1","first-page":"391","article-title":"Matrix Metalloproteinases in Wound Repair (Review)","volume":"6","author":"Ravanti L.","year":"2000","journal-title":"International Journal of Molecular Medicine"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1051\/ject\/200638174"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00008505-200110000-00002"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-008-9223-x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22041538"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scr.2010.11.003"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14113983"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS\u201021\u201012\u2010739"},{"key":"e_1_2_10_12_1","volume-title":"Platelet\u2010Rich Plasma Injections for Wound Healing and Tissue Rejuvenation: A Review of Clinical Effectiveness, Cost\u2010Effectiveness and Guidelines [Internet]","author":"Fleur P.","year":"2017"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12538"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/CWCMR.S118655"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm13030430"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006899.pub3"},{"issue":"1","key":"e_1_2_10_17_1","first-page":"56","article-title":"Stimulation of Repair in Chronic, Nonhealing, Cutaneous Ulcers Using Platelet\u2010Derived Wound Healing Formula","volume":"170","author":"Knighton D. 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R.","year":"2006","journal-title":"Ostomy\/Wound Management"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reth.2025.06.008"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(05)67700\u20108"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v2.i6.92"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2012.0403"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970\u20100358.101311"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S188655"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000396302.05959.d3"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8091486"},{"issue":"3","key":"e_1_2_10_30_1","first-page":"593","article-title":"Autologous Platelet\u2010Rich Plasma for Treatment of Venous Leg Ulcers: A Prospective Controlled Study","volume":"32","author":"Etugov D.","year":"2018","journal-title":"Journal of Biological Regulators and Homeostatic Agents"},{"issue":"5","key":"e_1_2_10_31_1","first-page":"298","article-title":"Venous Ulcers: Diagnosis and Treatment","volume":"100","author":"Bonkemeyer Millan S.","year":"2019","journal-title":"American Family Physician"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/1358836X9800300406"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2015.0635"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70932","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iwj.70932","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70932","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T03:46:20Z","timestamp":1779680780000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.70932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/iwj.70932"],"URL":"https:\/\/doi.org\/10.1111\/iwj.70932","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2026-01-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70932"}}