Martinez-Zapata MJ, Martí-Carvajal AJ, Solà I, Expósito JA, Bolíbar I, Rodríguez L, Garcia J, Zaror C, et al.
The Cochrane database of systematic reviews. Date of publication 2016 May 25;volume (5):CD006899.
1. Cochrane Database Syst Rev. 2016 May 25;(5):CD006899. doi:
10.1002/14651858.CD006899.pub3.
Autologous platelet-rich plasma for treating chronic wounds.
Martinez-Zapata MJ(1), Martí-Carvajal AJ, Solà I, Expósito JA, Bolíbar I,
Rodríguez L, Garcia J, Zaror C.
Author information:
(1)Iberoamerican Cochrane Centre - Biomedical Research Institute Sant Pau (IIB
Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Sant Antoni Maria
Claret 167, Pavilion 18, Barcelona, Catalunya, Spain, 08025.
Update of
Cochrane Database Syst Rev. 2012;10:CD006899.
BACKGROUND: Autologous platelet-rich plasma (PRP) is a treatment that contains
fibrin and high concentrations of growth factors with the potential to improve
the healing of chronic wounds. This is the first update of a review first
published in 2012.
OBJECTIVES: To determine whether autologous PRP promotes the healing of chronic
wounds.
SEARCH METHODS: In June 2015, for this first update, we searched the Cochrane
Wounds Specialised Register; the Cochrane Central Register of Controlled Trials
(CENTRAL) (The Cochrane Library): Ovid MEDLINE; Ovid MEDLINE (In-Process & Other
Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. We also searched for
ongoing and unpublished clinical trials in the WHO International Clinical Trials
Registry Platform (ICTRP) (searched January 2015). We did not impose any
restrictions with respect to language, date of publication, or study setting.
SELECTION CRITERIA: We included randomised controlled trials (RCTs) that compared
autologous PRP with placebo or alternative treatments for any type of chronic
wound in adults. We did not apply any date or language restrictions.
DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodology, including
two reviewers independently selecting studies for inclusion, extracting data, and
assessing risk of bias.
MAIN RESULTS: The search identified one new RCT, making a total of 10 included
RCTs (442 participants, 42% women). The median number of participants per RCT was
29 (range 10 to 117). Four RCTs recruited people with a range of chronic wounds;
three RCTs recruited people with venous leg ulcers, and three RCTs considered
foot ulcers in people with diabetes. The median length of treatment was 12 weeks
(range 8 to 40 weeks).It is unclear whether autologous PRP improves the healing
of chronic wounds generally compared with standard treatment (with or without
placebo) (risk ratio (RR) 1.19, 95% confidence interval (CI) 0.95 to 1.50; I(2) =
27%, low quality evidence, 8 RCTs, 391 participants). Autologous PRP may increase
the healing of foot ulcers in people with diabetes compared with standard care
(with or without placebo) (RR 1.22, 95% CI 1.01 to 1.49; I(2) = 0%, low quality
evidence, 2 RCTs, 189 participants). It is unclear if autologous PRP affects the
healing of venous leg ulcers (RR 1.02, 95% CI 0.81 to 1.27; I(2) = 0% ). It is
unclear if there is a difference in the risk of adverse events in people treated
with PRP or standard care (RR 1.05, 95% CI 0.29 to 3.88; I(2) = 0%, low quality
evidence from 3 trials, 102 participants).
AUTHORS' CONCLUSIONS: PRP may improve the healing of foot ulcers associated with
diabetes, but this conclusion is based on low quality evidence from two small
RCTs. It is unclear whether PRP influences the healing of other chronic wounds.
The overall quality of evidence of autologous PRP for treating chronic wounds is
low. There are very few RCTs evaluating PRP, they are underpowered to detect
treatment effects, if they exist, and are generally at high or unclear risk of
bias. Well designed and adequately powered clinical trials are needed.
DOI: 10.1002/14651858.CD006899.pub3
PMID: 27223580 [Indexed for MEDLINE]
