Li Y, Gao Y, Gao Y, Chen D, Wang C, Liu G, Yang X, Ran X, et al.
Journal of diabetes. Date of publication 2018 Sep 5;volume ():.
1. J Diabetes. 2018 Sep 5. doi: 10.1111/1753-0407.12850. [Epub ahead of print]
Autologous platelet-rich gel treatment for diabetic chronic cutaneous ulcers: A
meta-analysis of randomized controlled trials.
Li Y(1), Gao Y(1), Gao Y(1), Chen D(1), Wang C(1), Liu G(2), Yang X(3), Ran X(1).
Author information:
(1)Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West
China Hospital, Sichuan University, Chengdu, China.
(2)Chinese Cochrane Centre, Chengdu, China.
(3)Institute of Business Analytics, University of Alabama, Tuscaloosa, Alabama.
BACKGROUND: In recent years, many studies have reported that autologous
platelet-rich gel (APG) is an effective adjuvant treatment for chronic cutaneous
ulcers in diabetics. The aim of this study was to explore the efficacy and safety
of APG for the topical treatment of diabetic chronic cutaneous ulcers.
METHODS: The China Biology Medicine (CBM), China National Knowledge
Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals (VIP),
Chinese Wanfang database, PubMed, EMBASE, EBSCOhost, and Cochrane Library were
systematically searched for relevant studies published up to 18 October 2017.
Fixed- and random-effects models were used to calculate risk ratios (RR), odds
ratios (ORs), and mean difference (MD) with 95% confidence intervals (95% CI).
Subgroup analyses were conducted according to the Diabetic Foot Wagner
Classification.
RESULTS: Fifteen randomized control trials (RCTs) with 829 patients were eligible
for inclusion in this analysis. Compared with standard care or conventional
treatment, APG significantly improved the healing rate (RR 1.39; 95% CI 1.29,
1.50; P < 0.00001), shortened the healing time (MD -9.18; 95% CI -11.32, -7.05;
P < 0.00001), and reduced the incidence of infection (OR 0.34; 95% CI 0.15, 0.77;
P = 0.009).
CONCLUSIONS: Current evidence suggests that APG is effective and safe, and is
feasible for use as an adjuvant treatment for diabetic ulcers, especially chronic
refractory ulcers. However, more RCTs with a good design and of a high quality
are needed before the use of APG can be implemented widely.
© 2018 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John
Wiley & Sons Australia, Ltd.
DOI: 10.1111/1753-0407.12850
PMID: 30182534
