Platelet-Rich Fibrin (PRF) as a Regenerative Treatment for Chronic Diabetic Osteomyelitis and Its Therapeutic Potential

¹Emergency General Surgery Unit, A.U.O. City of Health and Science of Turin, Turin, Italy

²School of Medicine, University of Salerno Italy, Fisciano, SA, Italy

³Unit of Dermosurgery Cutaneous Transplantations and Hard-to-Heal Wound, “Villa Fiorita” Private Hospital, Aversa, CE, Italy

⁴Institute for the Studies and Care of Diabetics, Casagiove, CE, Italy

*Corresponding author: Alessandro Crisci, Unit of Dermosurgery Cutaneous Transplantations and Hard-to-Heal Wound, “Villa Fiorita” Private Hospital, Aversa, CE, Italy, Email: [email protected]

ORCID: https://orcid.org/0000-0002-4478-5714

Received Date: September 22, 2026

Published Date: November 14, 2026

Citation: Crisci M, Crisci A. (2026). Platelet-Rich Fibrin (PRF) as a Regenerative Treatment for Chronic Diabetic Osteomyelitis and Its Therapeutic Potential. Surgeries.6(1):15.

Copyright: Crisci M and Crisci A. © (2026).

ABSTRACT

The hypothesis is that the procedure of fibrin rich in leukocytes and platelets advanced (A-PRF) in ulcerative osteomyelitis of the diabetic foot (DFU) allows therapy from this critical illness. In this exploration, the focus was to standardize the use of platelet-rich fibrin (PRF) in patients not amputated with osteomyelitis, to use this second-generation platelet concentrate as a regeneration enabler. The researchers submitted and utilized A-PRF membranes (1300 g × 8 min) in 10 patients (all diabetics) with osteomyelitis and cutaneous injury for 6 months at least. The membranes, in amalgamation with the supernatant fluid produced by stress, have been integrated into the skin lesion down to the bone after surgical debridement. The progression of the lesions after some period of time has been analyzed. All 8 subjects had a probe-to-bone positive assay; magnetic resonance imaging indicated cortico-periosteal coagulation and/or foci of cortico-spongeous osteolysis contiguous to the lesion. Gram-positive bacteria were identified in our procedures in 52% of cases. Gram⁺ Cocci, for example, Staphylococcus aureus (15.6%), β-hemolytic Streptococci (12.1%), Streptococcus viridans (7.1%), and Gram-negative bacteria, for example, Pseudomonas (10.6%), Proteus (7.8%), Enterobacter (5.7%) were present. Candida albicans was active in 2.8% of cases. The blood count showed no relevant differences among different patients. To date, cutaneous lesions have been cured in 9 of the 10 subjects treated (1 patient for more than 8 years) without any evidence of infection or repetition. The results obtained on our subjects indicate that PRF membranes may be a therapeutic option in this problematic disease. In fact, this clinical approach may have the potential to support the healing of diabetic skin lesions with osteomyelitis.

Keywords: Chronic Osteomyelitis, Buffy Coat, Growth Factor Content, Platelet-Rich Fibrin