Wenchun Qu1, Zhen Wang2, Christine Hunt3, Allison S Morrow4, Meritxell Urtecho4, Mustapha Amin4, Sahrish Shah4, Bashar Hasan4, Rami Abd-Rabu4, Zack Ashmore5, Eva Kubrova6, Larry J Prokop7, Mohammad Hassan Murad4. 1. Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, MN; Department of Pain Medicine, Mayo Clinic, Jacksonville, FL. 2. Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, MN; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN. Electronic address: Wang.Zhen@mayo.edu. 3. Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, MN; Division of Pain Medicine, Department of Anaesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN. 4. Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, MN; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN. 5. Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, MN; Division of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN. 6. Department of Pain Medicine, Mayo Clinic, Jacksonville, FL. 7. Department of Library-Public Services, Mayo Clinic, Rochester, MN.
Abstract
OBJECTIVE: To evaluate the effectiveness and adverse events of autologous platelet-rich plasma (PRP) in individuals with lower-extremity diabetic ulcers, lower-extremity venous ulcers, and pressure ulcers. PATIENTS AND METHODS: We searched multiple databases from database inception to June 11, 2020, for randomized controlled trials and observational studies that compared PRP to any other wound care without PRP in adults with lower-extremity diabetic ulcers, lower-extremity venous ulcers, and pressure ulcers. RESULTS: We included 20 randomized controlled trials and five observational studies. Compared with management without PRP, PRP therapy significantly increased complete wound closure in lower-extremity diabetic ulcers (relative risk, 1.20; 95% CI, 1.09 to 1.32, moderate strength of evidence [SOE]), shortened time to complete wound closure, and reduced wound area and depth (low SOE). No significant changes were found in terms of wound infection, amputation, wound recurrence, or hospitalization. In patients with lower-extremity venous ulcers or pressure ulcers, the SOE was insufficient to estimate an effect on critical outcomes, such as complete wound closure or time to complete wound closure. There was no statistically significant difference in adverse events. CONCLUSION: Autologous PRP may increase complete wound closure, shorten healing time, and reduce wound size in individuals with lower-extremity diabetic ulcers. The evidence is insufficient to estimate an effect on wound healing in individuals with lower-extremity venous ulcers or pressure ulcers. TRIAL REGISTRATION: PROSPERO Identifier: CRD42020172817.
OBJECTIVE: To evaluate the effectiveness and adverse events of autologous platelet-rich plasma (PRP) in individuals with lower-extremity diabetic ulcers, lower-extremity venous ulcers, and pressure ulcers. PATIENTS AND METHODS: We searched multiple databases from database inception to June 11, 2020, for randomized controlled trials and observational studies that compared PRP to any other wound care without PRP in adults with lower-extremity diabetic ulcers, lower-extremity venous ulcers, and pressure ulcers. RESULTS: We included 20 randomized controlled trials and five observational studies. Compared with management without PRP, PRP therapy significantly increased complete wound closure in lower-extremity diabetic ulcers (relative risk, 1.20; 95% CI, 1.09 to 1.32, moderate strength of evidence [SOE]), shortened time to complete wound closure, and reduced wound area and depth (low SOE). No significant changes were found in terms of wound infection, amputation, wound recurrence, or hospitalization. In patients with lower-extremity venous ulcers or pressure ulcers, the SOE was insufficient to estimate an effect on critical outcomes, such as complete wound closure or time to complete wound closure. There was no statistically significant difference in adverse events. CONCLUSION: Autologous PRP may increase complete wound closure, shorten healing time, and reduce wound size in individuals with lower-extremity diabetic ulcers. The evidence is insufficient to estimate an effect on wound healing in individuals with lower-extremity venous ulcers or pressure ulcers. TRIAL REGISTRATION: PROSPERO Identifier: CRD42020172817.
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