Platelet-rich plasma (PRP) may be an effective treatment option for patients with vascular ulcers, a new study found. Despite the effectiveness of PRP for vascular ulcers, there does not seem to be a beneficial effect for patients with diabetic ulcers. Findings from this study were published in the Journal of Cosmetic Dermatology.
Researchers from China performed a systematic literature search to identify studies of PRP for cutaneous ulcerations that reported efficacy and safety outcomes. Trials included patients who were treated with PRP, platelet gel, platelet-concentrated plasma, or plasma-rich growth factors and patients with ≥1 ulcer (eg, vascular ulcer, decubitus ulcer, or diabetic ulcer). Studies eligible for inclusion reported ≥1 efficacy or safety outcome, including healing rate, final area, healing time, ulcer closure velocity, percentage area reduction, and adverse events (eg, anemia, contact dermatitis, edema, infection, and pain). A total of 19 randomized controlled trials with 909 patients were included in the meta-analysis.
Compared with conventional ulcer management, PRP was associated with a slightly better healing rate in the general pooled data (risk ratio [RR] 1.49; 95% CI, 1.10-2.02; P =.01), as well as the vascular subgroup (RR, 3.07; 95% CI, 1.05-9.04; P =.04). There was no difference between treatment strategies in the diabetic subgroup (RR, 1.28; 95% CI, 0.95-1.72; P =.10) and pressure subgroup (RR, 7.37; 95% CI, 0.99-54.94; P =.05).
In the vascular subgroup analysis, there was a significantly smaller final area (mean difference [MD], −7.57; 95% CI, −13.80 to −1.33; P =.02). No differences were observed in the overall dataset (MD, −1.27; 95% CI, −5.62 to 3.07; P =.57) and the diabetic subgroup (MD, 0.90; 95% CI, −3.31 to 5.11; P =.67) in the final area. For ulcer closure velocity, no differences were observed in the general pooled data (standard MD [SMD], 0.74; 95% CI, −0.12 to 1.60; P =.09) and the vascular (SMD, 0.27; 95% CI, −0.26 to 0.79; P =.32) and diabetic (SMD, 1.07; 95% CI, −0.40 to 2.54; P =.15) subgroups. There was no significant difference between groups in terms of healing time in the pooled data (MD, −26.61; 95% CI, −58.86 to 5.65; P =.11).
A limitation of the study included the variability in PRP preparation processes, dosages, and platelet concentrations.
According to their findings, the researchers suggested that a “PRP option should be carefully considered for each patient in accordance with their ulceration etiologies.”
Shen Z, Zheng S, Chen G, et al. Efficacy and safety of platelet-rich plasma in treating cutaneous ulceration: a meta-analysis of randomized controlled trials. J Cosmet Dermatol. 2019;18(2):495-507.