Full Text (PDF)
Case Report

Role of Prolotherapy in Wound Bed Preparation in Grade 4 Ischial Pressure Injuries

Ravi Kumar Chittoria, Sriram V.S., Amrutha J.S

Author Information

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator


Journal of Dermatology 10(1):p 17-20, jan-june 2025. | DOI: 10.21088/jd.2582.3582 10125.3

How Cite This Article:

Sriram VS, Chittoria RK, Amrutha JS. Role of prolotherapy in wound bed preparation in grade 4 ischial pressure injuries. RFP J Dermatol. 2025;10(1):17-20.

Timeline

Received : April 24, 2025         Accepted : May 10, 2025          Published : June 30, 2025

Abstract

Background: Hypoalbuminemia is prevalent in patients undergoing major abdominal surgeries and is associated with adverse postoperative outcomes, including prolonged hospital stays, higher infection rates, and increased mortality. The clinical impact of albumin supplementation in these patients remains under scrutiny. Objective: This study evaluates whether albumin supplementation in hypoalbuminemic patients (≤3.0 g/dL) improves postoperative outcomes. Methods: This retrospective study included patients who underwent major abdominal surgery between January 2021 and December 2024 at a tertiary care hospital. Patients with hypoalbuminemia were divided into two cohorts of 250 each: those who received postoperative albumin supplementation and those who did not. Outcomes measured included length of hospital stay (LOS), infection rates, ICU admission rates, and 30-day mortality. Results: The albumin supplementation group had a significantly shorter LOS (8.1 vs. 11.4 days, p < 0.001) and lower infection rates (10% vs. 17%, p = 0.02). There was no statistically significant difference in ICU admissions or 30-day mortality between the two groups (p = 0.58 and p = 0.19, respectively). Multivariate regression identified albumin supplementation as an independent predictor of reduced LOS and infection rates. Conclusion: Albumin supplementation in hypoalbuminemic patients post-major abdominal surgery improves recovery metrics by reducing LOS and infection rates without influencing short-term mortality. Future randomized controlled trials arenecessary to validate these findings.


References

  • 1.   Sato T., Abe T., Ichioka S. Factors impairing cell proliferation in the granulation tissue of pressure ulcers: Impact of bacterial burden. Wound Repair Regen Off Publ Wound Heal Soc Eur Tissue Repair Soc. 2018; 26: 284–92.
  • 2.   Siadat A.H., Isseroff R.R. Prolotherapy: Potential for the Treatment of Chronic Wounds? Adv Wound Care. 2019; 8: 160–7.
  • 3.   Edsberg L.E., Black J.M., Goldberg M., McNichol L., Moore L., Sieggreen M. Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System. J Wound Ostomy Continence Nurs. 2016; 43: 585–97.
  • 4.   Cooper D.M., Yu E.Z., Hennessey P., Ko F., Robson M.C. Determination of endogenous cytokines in chronic wounds. Ann Surg. 1994; 219: 688–92.
  • 5.   Schultz G.S., Sibbald R.G., Falanga V., Ayello E.A., Dowsett C., Harding K., et al. Wound bed preparation: a systematic approach to wound management. Wound Repair Regen Off Publ Wound Heal Soc Eur Tissue Repair Soc. 2003; 11 Suppl 1: S1-28.
  • 6.   Harries R.L., Bosanquet D.C., Harding K.G. Wound bed preparation: TIME for an update. Int Wound J. 2016; 13: 8–14.
  • 7.   Bae G., Kim S., Lee S., Lee W.Y., Lim Y. Prolotherapy for the patients with chronic musculoskeletal pain: systematic review and meta-analysis. Anesth Pain Med. 2021; 16: 81–95.
  • 8.   Oh J.Y., Choi G.E., Lee H.J., Jung Y.H., Ko S.H., Chae C.W., et al. High Glucose-Induced Reactive Oxygen Species Stimulates Human Mesenchymal Stem Cell Migration Through Snail and EZH2-Dependent E-Cadherin Repression. Cell Physiol Biochem Int J Exp Cell Physiol Biochem Pharmacol. 2018; 46: 1749–67.
  • 9.   Wu T.J., Fong Y.C., Lin C.Y., Huang Y.L., Tang C.H. Glucose enhances aggrecan expression in chondrocytes via the PKCα/p38-miR141-3p signaling pathway. J Cell Physiol. 2018; 233: 6878–87.
  • 10.   Rabago D., Lee K.S., Ryan M, Chourasia A.O., Sesto M.E., Zgierska A., et al. Hypertonic dextrose and morrhuate sodium injections (prolotherapy) for lateral epicondylosis (tennis elbow): results of a single-blind, pilot-level, randomized controlled trial. Am J Phys Med Rehabil. 2013; 92: 587–96.
  • 11.   Scarpone M., Rabago D.P., Zgierska A., Arbogast G., Snell E. The efficacy of prolotherapy for lateral epicondylosis: A pilot study. Clin J Sport Med Off J Can Acad Sport Med. 2008; 18: 248–54.
  • 12.   Barrientos S., Stojadinovic O., Golinko M.S., Brem H., Tomic-Canic M. Growth factors and cytokines in wound healing. Wound Repair Regen Off Publ Wound Heal Soc Eur Tissue Repair Soc. 2008; 16: 585–601.

Data Sharing Statement

There are no additional data available

Funding

This research received no funding

Author Contributions

All authors contributed significantly to the work and approve its publication

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval

Acknowledgements

Information Not Provided

Conflicts of Interest

No conflicts of interest in this work


About this article


Cite this article

Sriram VS, Chittoria RK, Amrutha JS. Role of prolotherapy in wound bed preparation in grade 4 ischial pressure injuries. RFP J Dermatol. 2025;10(1):17-20.


Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator


Received Accepted Published
April 24, 2025 May 10, 2025 June 30, 2025

DOI: 10.21088/jd.2582.3582 10125.3

Keywords

Hypoalbuminemia <3.5 g/dLLength of hospital stay(LOS)Albumin supplementation

Article Level Metrics

Last Updated

Friday 29 May 2026, 01:58:47 (IST)


281

Accesses

3
91
00

Citations


NA
NA
NA

Download citation


Article Keywords


Keyword Highlighting

Highlight selected keywords in the article text.


Timeline


Received April 24, 2025
Accepted May 10, 2025
Published June 30, 2025

licence


Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator


Access this article



Share