Clinical studies on platelet-rich plasma (PRP) therapy for chronic cutaneous ulcers: a systematic review and meta-analysis of randomized controlled trials

Sun Yat-sen University First Affiliated Hospital, 71068, Department of Burn Surgery, Department of Neurosurgery, Guangzhou, Guangdong, China; 370063299@qq.com. Sun Yat-sen University First Affiliated Hospital, 71068, Department of Burn Surgery, Guangzhou, Guangdong, China; willway128@163.com. Affiliated Hospital of Nantong University, 74567, Department of Burn and Plastic Surgery, Nantong, China; 198zy@163.com. Sun Yat-sen University First Affiliated Hospital, 71068, Department of Burn Surgery, Guangzhou, Guangdong, China; 18565280351@163.com. Sun Yat-sen University First Affiliated Hospital, 71068, Department of Plastic Surgery, Guangzhou, Guangdong, China; 315055459@qq.com. Sun Yat-sen University First Affiliated Hospital, 71068, Department of Burn Surgery, Guangzhou, Guangdong, China; 452238356@qq.com. Sun Yat-sen University First Affiliated Hospital, 71068, Department of Burn Surgery, Guangzhou, Guangdong, China; 591950554@qq.com. Sun Yat-sen University First Affiliated Hospital, 71068, Guangzhou, Guangdong, China; xuhailin_sysu@163.com. Sun Yat-sen University First Affiliated Hospital, 71068, Department of Burns, Guangzhou, Guangdong, China; rongyanchao_1995@163.com. Portland State University, 6685, Department of Chemistry, Portland, Oregon, United States; 2658157541@qq.com. Sun Yat-sen University First Affiliated Hospital, 71068, Department of Burn and Plastic Surgery, guangzhou, Guangzhou, China, 510080; tangbing@mail.sysu.edu.cn. Sun Yat-sen University First Affiliated Hospital, 71068, Department of Burn Surgery, Guangzhou, Guangdong, China; zhujiay@mail.sysu.edu.cn.

Advances in wound care. 2021
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Abstract
SIGNIFICANCE Platelet-rich plasma (PRP) may be a potential drug for treatment of chronic refractory ulcers, which increase the risk of systemic infection and local canceration. However, the efficacy and safety of clinical application of PRP are still controversial. Thus, this study was aimed to assess the efficacy and safety of PRP in patients with chronic ulcers. Recent Advances: For this meta-analysis, Cochrane's Library, MEDLINE, EMBASE, PubMed, and Web of Knowledge databases were searched. Results were pooled using a random-effects model. The primary outcome was the proportion of completely healed chronic ulcers. CRITICAL ISSUES Seventeen randomized controlled trials (RCTs) were included. Compared with the control group, PRP significantly increased the fraction of healed ulcers (pooled RR =1.50; 95% CI 1.20 to 1.87; I2=47.8%). In autologous PRP (APRP) and homologous PRP (HPRP) subgroups, there were statistical differences between the control group vs. treatment subgroup (pooled RR=1.30, 95% CI 1.10 to 1.54, I2=25.7%; pooled RR=3.53, 95% CI 1.94 to 6.43, I2=0.0%, respectively). In terms of percent of chronic ulcers area healed, there was a statistically significant difference between the PRP-treated group vs. the control group (SMD=1.37, 95%CI=0.91 to 1.82, I2=22.1 %). As for PRP safety, there existed a statistically significant difference between the APRP subgroup and the HPRP subgroup, respectively (pooled RR=0.58; 95% CI 0.35 to 0.98; I2=0.0%) and (pooled RR=4.12; 95% CI 1.55 to 10.96; I2=6.8%). FUTURE DIRECTIONS Our findings shows that PRP may be a beneficial treatment of chronic skin ulcers and that APRP may be much safer than HPRP.
Study details
Study Design : Systematic Review
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine