PhD Scientific Days 2023

Clinical Medicine VI.

Platelet-rich plasma in chronic wound management.

Text of the abstract

Introduction: Chronic wounds place a heavy burden on the healthcare system as the cost of wound management is estimated to account for 5.5% of all healthcare expenditures.
Aims: Our aim was to investigate the therapeutic effects of platelet-rich plasma on the treatment of chronic wounds.
Method: Our systematic review and meta-analysis are reported according to the PRISMA 2020 Statement. The systematic literature search was performed in four databases: MEDLINE (via PubMed), Cochrane Library (CENTRAL), Embase, and Web of Science, from inception to 29th October, 2021. The review protocol was registered on PROSPERO under registration number CRD42021287881. Randomized clinical trials reporting on patients with chronic wounds treated with platelet-rich plasma were included, comparing platelet-rich plasma (intervention) with conventional ulcer therapy (control). Two authors independently extracted relevant data into a pre-defined data sheet, and a third reviewer resolved discrepancies between the two authors. We pooled data using the random effects model. Our primary outcome was the change in wound size; secondary outcomes were healing time, infection, pain, adverse events, amputation, recurrence, and quality of life.
Results: Our systematic search provided a total of 2,688 articles, and we identified 48 eligible studies after selection and citation search. Thirty-three study groups of 29 RCTs with a total of 2,198 wounds showed that the odds for complete closure were significantly higher in the PRP group than in the control group (OR=5.32; CI: 3.37; 8.40; I2=58%), whereas pooled standardized mean differences from 16 studies showed a significant difference between the post-treatment wound size of the intervention and the control groups (SMD = -1.21, CI: -1.74; -0.65; I2 = 92.5%), the PRP group showing greater improvement.
Conclusions: Platelet-rich plasma is a safe and effective modality to enhance wound healing. By implementing it in clinical practice, platelet-rich plasma could become a widely used, valuable tool as it could not only improve patients’ quality of life but also decrease the healthcare burden of wound management.
Funding: The research was supported by Semmelweis 250+ Excellence Scholarship.