Background: Chronic wound healing is a major health problem. In addition to suffering and pain, failure of healing process also had financial and social burdens. Because these wounds lack the necessary growth factors for healing, they are often difficult to heal and are frequently complicated by superinfection. Chronic non healing leg ulcer is defined as skin loss on the leg or foot for more than 6 weeks with no signs of healing. Chronic ulceration of the lower leg including the foot is a frequent condition causing pain, social discomfort, and generating considerable costs. Objective: to compare between the effect of autologous platelet rich plasma (PRP) and Vacuum Assisted Closure Therapy (VAC) in management of chronic leg ulcers regarding to Pressure Ulcer Scale for Healing (PUSH) including surface area of the ulcer , exudate amount and tissue type of the ulcer bed. Patients and Methods: Fifty two adult patients with a history of chronic leg ulcers that not healed for six weeks or more despite treatment of the underlying causes and appropriate local wound treatment. They are divided into two equal groups. Results: The two studied groups had shown no difference regarding age, gender and special habits according to demographic data. There were no differences between the two studied groups regarding clinical data of wound character. In healing process, the first group was shown complete healing in 16 patients by secondary intension, incomplete healing in 10 patients who need skin graft. In second group the patients were shown complete healing in 5 patient by secondary intension, incomplete healing in 21 patients who need skin graft. With a significant difference (p = 0.040). Conclusion: There is no appropriate dressing for all types of wounds, so assessment and continuous observation of the characteristics of the wounds should be done to decide the proper dressing required. The use of negative pressure wound therapy and platelet-rich plasma can be a tool in management of chronic wounds which had no improvement with conventional dressing. It should be reserved to wounds that do not show any progress after 3 weeks with treatment of wound etiology and standard wound care. PRP is simpler, safer, less costly, shorter time for wound healing, less painful, no hospital admission so less transmission of infection and autologous nature in the preparation had proved the superiority of PRP over VAC therapy.

Keywords: Vacuum assisted closure therapy, platelet rich plasma.