Objective:Immunomodulation of non-healing wounds with the use of placental extract, as an agent for topical application

Methods: A case-control study of 50 patients in the study group (Group A) and 50 patients in the control group (Group B) was conducted at K. J. Somaiya Medical College and Research Centre, Mumbai, India. The patients selected had non-healing wounds either in the form of ulcers on the lower extremity or pressure sores. Patients in group A had placental extract (PLACENTREX) applied during dressing while group-B patients had dressings done with normal saline. All patients with gross necrotic infection underwent surgical debridement once. Efficacy of the PLACENTREX application was assessed
   (1) on the basis of MAGS (Microscopic

Angiogenesis Grading System) by looking for Vasoproliferation (N), Endothelial Cell Hyperplasia (E) and Endothelial Cytology (X); the score was calculated as KnN + KeE + KxX,
and
   (2) clinically on the basis of decrease in mean surface area, no signs of local inflammation and no slough or discharge from the wounds. The end point of the study was determined as the development of healthy, pink, pin-point, velvety granulation tissue without infection. The adverse effects due the application of placental extract, if any, were to be noted.

Results: Results were tabulated in all patients including controls. Statistical analysis was done using the unpaired t-test and p-values were determined. 1) A considerably higher MAGS Score was seen in group-A patients. 2) In group-A patients the mean surface area of wounds decreased from 31.52cm2 to 17.53cm2 at the end point of the study while a much lesser decrease was seen in the control group. The clinical end point of the study was

reached in approximately 19 days in group A and about 36 days in group B. Negligible side effects of Placentrex were seen.

Conclusion: Placental extract in the form of PLACENTREX was found to be an effective, easily available and cheap agent with no side effects as a topical agent in the treatment of non-healing wounds.

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