Title : Induction of neo angiogenesis: A way forward for reversing necrosis in complex wounds in orthopaedic practice
Abstract:
Introduction: The functional integrity of limbs depends on healthy bones, tendons, and soft-tissue cover. High-velocity trauma has led to an increase in complex wounds exposing these vital structures, often with extensive devitalization of overlying tissues. This precipitates a cycle of necrosis, infection, and progressive tissue loss. Conventional management — including debridement, medical care, and flap coverage — addresses the deficit but rarely restores compromised tissue. Regenerative strategies, particularly Platelet rich plasma (PRP), induce neo-angiogenesis, potentially transforming wound care from reparative to regenerative. This study evaluates whether targeted regenerative intervention can preserve and revive tissues otherwise destined for necrosis.
Study Design: This prospective clinical study investigates autologous Platelet-Rich Plasma (PRP) as a stand-alone therapy in complex orthopedic wounds. Freshly prepared PRP was infiltrated subcutaneously around, beneath, and within devitalized tissues using a standardized protocol, “Sandeep’s Protocol for Induction of Neo-Angiogenesis (SPIN).
Observations & Results: Outcome measures included tissue survival, wound healing quality, pain, infection control, and regenerative signs in necrosed zones. Application of the SPIN protocol consistently demonstrated:
• Revival of previously non-viable tissues
• Reduction in infection-related complications
• Effective pain management and improved healing trajectory
The protocol was safe, reproducible, and clinically adaptable.
Conclusion: Regenerative wound care through neo-angiogenesis represents a paradigm shift in orthopedic management. PRP, with growth-promoting, antimicrobial, and immunomodulatory properties, offers a biologic tool to break the necrosis-infection cycle. The SPIN protocol is simple, cost-effective, and accessible, bridging conventional coverage with true tissue regeneration and potentially redefining outcomes in complex trauma care.
