“Platelet-Rich Fibrin Membrane-as a novel biomaterial for pressure injury healing in a person with spinal cord injury: A case report”

INTRODUCTION: Pressure injury (PI) impacts the quality of life, and socioeconomic and psychological well-being negatively in persons with Spinal Cord Injury (SCI). Autologous Platelet Rich Plasma (PRP) and Platelet Rich Fibrin (PRF) showed promising roles in wound healing. PRF is considered a second-generation PRP, contains more growth factors and is more biocompatible than PRP. It possesses an additional favourable impact on wound healing due to its three-dimensional fibrin architecture, and antimicrobial property. There are no studies on PRF membrane use for PI healing in SCI. CASE PRESENTATION: A 25-year-old male with operated traumatic T10 American Spinal Injury Association Impairment Scale grade A paraplegia with neurogenic bowel, and bladder and a stage II PI over the left greater trochanter, was admitted for inpatient rehabilitation. The chronic non-healing PI which did not show any improvement following normal saline (0.9%) dressing for the past 3 months, was treated with autologous PRF membrane weekly for four weeks. The PI healed completely and no adverse events were noted. Weekly total scores of the Spinal Cord Impairment Pressure Ulcer Monitoring Tool and Pressure Ulcer Scale for Healing were 6, 6, 5, 2, 0 and 12, 10, 10, 3, and 0 respectively. DISCUSSION: To the best of our knowledge, this is the first case report on the healing of PI in SCI with the use of PRF. This novel biomaterial is a safe and effective promising agent for PI management in SCI. But further randomized trials are needed to establish stronger evidence regarding feasibility and effectiveness.