Role of addition of Stem Cells or Platelet Rich Fibrin in the healing of chronic lower extremity venous ulcers compared to Endo Venous Laser Ablation alone.

Chronic venous ulcers are a significant health burden, often leading to prolonged morbidity and reduced quality of life. Conventional treatment strategies, including compression therapy and surgical interventions, have limitations in healing time and recurrence rates. Endovenous Laser Ablation (EVLA) is an effective modality for treating underlying venous insufficiency; however, it does not directly promote ulcer healing. Recent advances in regenerative medicine have introduced autologous stem cells and platelet-rich derivatives such as PRF as promising adjuncts to enhance tissue repair. This randomized, prospective, interventional study aims to evaluate and compare the effectiveness of three treatment modalities: 1. EVLA alone (control group) 2. EVLA with perilesional injection of autologous stem cells (mesenchymal stem cells derived from bone marrow) 3. EVLA with perilesional injection of autologous platelet-rich fibrin (PRF) Patients diagnosed with chronic venous ulcers due to superficial venous insufficiency will be randomly assigned into one of the three treatment groups. The primary outcome measure will be the rate of ulcer healing, assessed by reduction in ulcer size and complete healing over a 6-month period. Secondary outcomes will include recurrence rate at 6 months and any adverse events related to the procedures. This study is expected to provide evidence regarding the utility of biologic adjuncts like stem cells and PRF in accelerating healing and improving outcomes in venous ulcer patients, potentially shaping future management protocols for chronic wounds.