Use of platelet rich plasma gel on wound healing: a systematic review and meta-analysis

Marissa J Carter, Carelyn P Fylling, Laura K S Parnell, Marissa J Carter, Carelyn P Fylling, Laura K S Parnell

Abstract

Objective: Autologous platelet rich plasma is an advanced wound therapy used in hard-to-heal acute and chronic wounds. To better understand the use and clinical outcomes of the therapy, a systematic review of the published literature in cutaneous wounds was performed.

Methods: Electronic and hand searches for randomized controlled trials and comparative group studies using platelet rich plasma therapy in cutaneous wounds and published over the last 10 years was conducted. Eligible studies compared the treatment to standard care or other interventions. All citations were screened and eligible studies were assessed for validity, quality, and bias using accepted scoring methods. The primary outcomes were effect of platelet rich plasma and control wound care on wound healing and related healing measurements. Secondary outcomes related to healing such as infection, pain, exudate, adverse events, and quality of life were also considered. The meta-analysis utilized appropriate statistical methods to determine the overall treatment effect on chronic and acute wound healing and infection.

Results: The search terms resulted in 8577 citations and after removing duplicates and screening for protocol eligibility, a total of 24 papers were used. The meta-analysis of chronic wound studies revealed platelet rich plasma therapy is significantly favored for complete healing. The meta-analysis of acute wounds with primary closure studies demonstrated that presence of infection was reduced in platelet rich plasma treated wounds.

Conclusions: This systematic review and meta-analysis of platelet rich plasma therapy in cutaneous wounds showed complete and partial wound healing was improved compared to control wound care.

Figures

Figure 1
Figure 1
Systematic review of platelet rich plasma literature, March 2001 to March 2011. Template from Moher D, Liberati A, Tetzlaff J, Altman DG; The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 6(6): e1000097. doi:10.1371/journal.pmed1000097
Figure 2
Figure 2
Meta-analysis: Forest plot of chronic wound complete wound healing studies treated with standard wound care and either PRP or control agent. This analysis used the least conservative PP analysis for Driver et al. CI indicates confidence interval; df, degrees of freedom; M-H, Mantel-Haenszel; PRP, platelet-rich plasma.
Figure 3
Figure 3
Meta-analysis: Forest plot of acute wounds with primary closure for superficial infection treated with standard wound care and either PRP or control agent. CI indicates confidence interval; df, degrees of freedom; M-H, Mantel-Haenszel; PRP, platelet-rich plasma.
Figure 4
Figure 4
Meta-analysis: Forest plot of acute wounds with primary closure for pain reduction treated with standard wound care and either PRP or control agent. CI indicates confidence interval; df, degrees of freedom; M-H, Mantel-Haenszel; PRP, platelet-rich.

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