Comparison of Platelet-Rich Plasma Dressing Versus Normal Saline Dressing for Chronic Non-Healing Ulcers

Inclusion Criteria: * Age 18 years or above * Either gender * Chronic non healing cutaneous ulcer of at least 6 weeks duration * Ulcer etiology eligible for conservative dressing-based management, including * Diabetic foot, Venous leg and Pressure ulcer * Other chronic ulcers considered suitable by the treating dermatologist * Measurable index ulcer surface area suitable for standardized photography and planimetric assessment * Clinically acceptable wound bed after initial wound bed preparation * No requirement for urgent surgical reconstruction at enrolment * Ability to attend twice weekly dressing visits for 6 weeks * Provision of written informed consent Exclusion Criteria: * Suspected or proven malignant ulceration * Vasculitic or inflammatory ulcers requiring systemic immunosuppression * Pyoderma gangrenosum * Critical limb ischemia or severe perfusion compromise on clinical assessment, with vascular screening where feasible * Requirement for urgent revascularization * Active osteomyelitis requiring bony debridement * Exposed bone with high suspicion of osteomyelitis * Rapidly spreading soft tissue infection * Systemic sepsis * Hematological abnormalities making venesection or platelet rich plasma preparation unsafe, including * Clinically relevant platelet dysfunction * Known bleeding diathesis * Therapeutic anticoagulation where temporary interruption is not clinically appropriate * Pregnancy or lactation * Participation in another interventional wound trial * Inability to comply with follow up