{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T09:53:55Z","timestamp":1776678835038,"version":"3.51.2"},"reference-count":23,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Chronic wounds that fail to respond to standard wound care (SWC) remain a major clinical challenge. Platelet-rich plasma (PRP) is an advanced regenerative therapy that delivers platelet-derived growth factors involved in angiogenesis and tissue repair. However, clinical data in Asian populations and evidence regarding ulcers associated with vasculitis or microangiopathic ischemia remain limited. This study evaluated the efficacy, safety, and treatment frequency of autologous PRP gel prepared using the newly approved AutoloGel System\u00ae in Japan. Methods: This single-center retrospective study included 20 patients with chronic ulcers unresponsive to \u226528 days of conventional therapy by a wound specialist. PRP gel was applied weekly for up to eight sessions under current insurance coverage. Primary outcomes were wound healing rate at 12 weeks after PRP initiation and healing duration. Healing time during specialist-directed conventional therapy was compared with that following PRP using the Wilcoxon signed-rank test. Results: Twenty patients (mean age 60 \u00b1 15 years) with diverse refractory ulcers\u2014including diabetic foot ulcers, chronic limb-threatening ischemia, vasculitic ulcers, venous leg ulcers, pressure ulcers, and surgical site infections\u2014were analyzed. All wounds achieved complete epithelialization within 12 weeks. Healing time decreased significantly from 87.2 \u00b1 77.1 days during conventional therapy to 47.9 \u00b1 28.5 days after PRP initiation (median 60 vs. 44 days, p = 0.0107). No treatment-related adverse events were observed. Conclusions: Weekly autologous PRP gel therapy prepared using the AutoloGel System\u00ae was associated with improved healing outcomes in refractory chronic wounds. Favorable outcomes were observed in traditionally difficult-to-treat conditions, including vasculitis-associated and microangiopathic ischemic ulcers. These findings suggest the potential role of PRP in promoting angiogenesis and improving microcirculatory perfusion in wounds associated with microvascular dysfunction.<\/jats:p>","DOI":"10.3390\/jcm15083120","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:24:23Z","timestamp":1776673463000},"page":"3120","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Single-Institution Cohort Study of Autologous Platelet-Rich Plasma Gel for Hard-to-Heal Chronic Wounds: Potential Role in Microvascular Regeneration"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6327-5886","authenticated-orcid":false,"given":"Miki","family":"Fujii","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuki","family":"Shimada","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takako","family":"Komiya","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8788-7684","authenticated-orcid":false,"given":"Hajime","family":"Matsumura","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Schilrreff, P., and Alexiev, U. 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