Efficacy and safety of the use of platelet-rich plasma to manage venous ulcers

Cardeñosa, Manuel Escamilla; Domínguez-Maldonado, Gabriel; Córdoba–Fernández, Antonio

doi:10.1016/j.jtv.2016.11.003

Cited by 38 publications

(48 citation statements)

References 21 publications

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“…Autologous platelet‐rich plasma (PRP) has been used for 30 years in a variety of surgical situations, including blood loss reduction and promotion of tissue regeneration . Although individual small‐scale studies reported an effective use of PRP in VLU management, strong evidence for its effectiveness from high‐quality randomized controlled trials (RCTs) is lacking.…”

Section: Introductionmentioning

confidence: 99%

Adjuvant therapies in venous leg ulcer management: A scoping review

Team

Chandler

Weller

2019

Wound Repair Regeneration

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Compression therapy is the current evidence-based approach to manage venous leg ulcers (VLU); however, adherence is a major barrier to successful treatment. Combination approaches may relieve the burden of treatment by shortening the time to ulcer healing. This scoping review conducted by Australian researchers aimed to establish the evidence of effectiveness of various adjuvant methods on wound healing and recurrence. Randomized Controlled Trials (RCTs), and Systematic Reviews (SR) and Meta-Analyses (MA) on VLU management approaches published from January 2015 to December 2018 were included in this review. The articles included in the scoping review were grouped according to the management approaches, including (1) pharmaceutical interventions, (2) surgical interventions, (3) topical agents, (4) the use of devices, and (5) other, such as physiotherapy and psychological interventions. Results of this scoping review indicate that there is a limited high-quality evidence of effectiveness in most adjuvant therapies on wound healing and recurrence. Given the lowquality evidence observed in this scoping review for adjuvant treatments, the implication for practice is that current management guidelines be followed. Further rigorous studies have the potential to produce better quality evidence. Quality of evidence can be improved by ensuring large sample sizes of a single etiology wounds, standardizing reporting outcomes, and maintaining detailed and evidence-based protocols in physiological or psychological interventions.

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Section: Introductionmentioning

confidence: 99%

Adjuvant therapies in venous leg ulcer management: A scoping review

Team

Chandler

Weller

2019

Wound Repair Regeneration

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“…The final area was documented in four studies . There was significant difference in vascular subgroup analysis (MD = −7.57, 95%CI: [−13.80, −1.33], P = 0.02, I 2 = 0%; Figure ), while no differences were observed in the overall pooled and diabetic subgroup results (MD = −1.27, 95%CI: [−5.62, 3.07], P = 0.57, I 2 = 68%; MD = 0.90, 95%CI: [−3.31, 5.11], P = 0.67, I 2 = 73%, respectively, Figure ).…”

Section: Resultsmentioning

confidence: 98%

“…We excluded another 29 articles for reasons like non‐RCTs, lack of useful outcome data, basic research, and introduction of a surgery technique. Finally, 19 RCTs were included in the meta‐analysis (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…As is shown in Figure , all studies involved random sequence generation. The methods of randomization were detailed in only 10 of the studies, in eight of which appropriate random sequence was generated; However, two used inappropriate randomization (one was randomized by date of birth, and the other was randomized by sealed envelope), which resulted in categorization as “high risk” (Figure ). Adequate allocation concealment was reported in eight of the studies .…”

Section: Resultsmentioning

confidence: 99%

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Efficacy and safety of platelet‐rich plasma in treating cutaneous ulceration: A meta‐analysis of randomized controlled trials

Shen

Zheng

Guo-qian

et al. 2019

J of Cosmetic Dermatology

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Summary Background The biological mechanisms underlying the use of platelet‐rich plasma (PRP), as well as the efficacy and possible adverse effects of PRP, have not yet been fully elucidated. Prior studies have evaluated PRP for cutaneous ulceration. However, the benefits from PRP still remain controversial and few have assessed the effects of ulceration etiologies. The purpose of our study is to determine the efficacy and safety of PRP and which kind of ulcer is more suitable for PRP by analyzing the effects of PRP on ulcers with different causes. Methods A comprehensive search was performed to identify randomized controlled trials (RCTs) regarding the application of PRP from PubMed, EMBASE, Scopus, and the Cochrane Library. The data were analyzed using Review Manager 5.3. Results A total of nineteen RCTs (909 patients) were included. In contrast with conventional treatments, PRP achieved higher healing rate, higher percentage of area reduction, and smaller final area in vascular ulcers. However, the advantage disappeared in diabetic and pressure ulcers. Concerning adverse events, PRP showed lower incidence in the short term, but higher in the long term. No significant differences were found in ulcer closure velocity and healing time. Conclusion Platelet‐rich plasma effectiveness and safety in treating cutaneous ulceration depend on what is the ulceration etiology. For diabetic ulcers, PRP showed no satisfactory results suggesting that PRP may not be suitable for diabetic patients. However, PRP could be efficient and more beneficial for vascular ulcers and effects on pressure ulcers remain unclear. Thus, PRP option should be carefully considered for each patient in accordance with their ulceration etiologies.

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“…Platelet-rich plasma (PRP) is a platelet concentrate 3-5 times higher than the normal count, obtained through centrifugation of a sample of the patient's own blood. Since the 1990s PRP has been used in several different fields of regenerative medicine (6,7). The potential therapeutic effect of PRP is based on its ability to improve tissue regeneration by releasing growth factors present in platelet alpha granules (8).…”

Section: Introductionmentioning

confidence: 99%

Can platelet-rich plasma coating improve polypropylene mesh integration? An immunohistochemical analysis in rabbits

et al. 2021

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Purpose: Despite high success rates in the treatment of urinary incontinence, complications related to the use of polypropylene (PP) meshes are still a concern, especially in vaginal prolapses surgeries. The objective of this study was to assess the effect of autologous platelet-rich plasma (PRP) coating on the integration of PP meshes implanted in the vaginal submucosa of rabbits. Materials and Methods: Thirty adult New Zealand rabbits were randomly divided into two groups (n=15): PP, implanted with conventional PP meshes; and PRP, implanted with autologous PRP coated PP meshes. Animals in both groups (n=5) were euthanized at 7, 30 and 90 days postoperatively, the vaginas extracted and sent to immunohistochemical analysis for the assessment of the pro-inflammatory agent TNF-α, anti-inflammatory agents TGF-β and IL-13, collagen metabolism marker MMP-2, and angiogenesis marker CD-31. AxioVision™ image analysis was used for the calculation of the immunoreactive area and density. Statistical analysis was performed with ANOVA followed by Tukey test (p <0.05). Results: Animals in the PRP group showed significantly increased expression of the angiogenesis agent CD-31 at all experimental times when compared to the PP group (p <0.0001). However, no differences concerning the expression of the other markers were observed between the groups. Conclusion: The addition of autologous PRP gel to PP meshes can be simply and safely achieved and seems to have a positive effect on implantation site angiogenesis. Further investigations are required to ascertain PPR coated meshes clinical efficacy in prolapses and stress urinary incontinence surgeries.

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Efficacy and safety of the use of platelet-rich plasma to manage venous ulcers

Cited by 38 publications

References 21 publications

Adjuvant therapies in venous leg ulcer management: A scoping review

Adjuvant therapies in venous leg ulcer management: A scoping review

Efficacy and safety of platelet‐rich plasma in treating cutaneous ulceration: A meta‐analysis of randomized controlled trials

Can platelet-rich plasma coating improve polypropylene mesh integration? An immunohistochemical analysis in rabbits

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