Autologous platelet-rich plasma for treating chronic wounds

Abstract

PRP may improve the healing of foot ulcers associated with diabetes, but this conclusion is based on low quality evidence from two small RCTs. It is unclear whether PRP influences the healing of other chronic wounds. The overall quality of evidence of autologous PRP for treating chronic wounds is low. There are very few RCTs evaluating PRP, they are underpowered to detect treatment effects, if they exist, and are generally at high or unclear risk of bias. Well designed and adequately powered clinical trials are needed.

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“…6,7 Platelet-rich preparations have been proposed as an alternative option to enhance wound healing when other strategies fail, and papers showing encouraging results with the use of PRP and PG are available. 3 Randomized clinical trials comparing platelet-rich derivatives to standard or advanced wound management are lacking, and to date, there is a paucity of studies that assess the role of PRP and PG in infected wounds. 8 Moreover, most of the data refer only to platelet mixtures obtained from autologous whole blood.…”

“…Unfortunately, randomized controlled trials evaluating the efficacy of PRP compared with standard or advanced wound management are still lacking and the current literature mostly refers to anecdotal reports in patients with no evidences of wound infection. 3 This case report documents a kidney transplant recipient who experienced spontaneous bladder rupture because of gangrenous cystitis. After an exploratory laparotomy and bladder repair, the patient developed a deep surgical site infection by multidrug resistant Acinetobacter baumannii and extensive wound dehiscence.…”

Platelet-rich plasma for the treatment of chronic wounds: evidence to date

“…No adverse effects, such as increased risk of infection or hypersensitivity reactions, have been detected in clinical trials. 25 Regarding oncogenic potential, when possible coincidences between carcinogenesis and the mitogenic pathways employed by growth factors have been evaluated, no evidence supports a possible tumoral triggering. Once a growth factor has joined its membrane receptor, intracellular signal cascades are activated, normal genetic expression is promoted, and different control mechanisms regulate this process.…”

Is there a treatment protocol in which platelet-rich plasma is effective?

“…20,21 Recently, the use of PRP has gained popularity and has become a treatment option all by itself. 22 There are some questions to be answered such as to whom, when, how and by which mechanism it is to be applied. It is important that a standardization be processed in consequence of basic and clinical studies as using different commercial kits might result in different results, which leads some issues concerning the evaluation of clinic studies.…”