Autologous platelet‐rich plasma versus conventional therapy for the treatment of chronic venous leg ulcers: A comparative study

Moneib, Hoda; Youssef, Sahar; Aly, Dalia Gamal; Rizk, Mohamed Abd El-Monem Abd El-Salam; Abdelhakeem, Yomna I

doi:10.1111/jocd.12401

Cited by 64 publications

(66 citation statements)

References 16 publications

(23 reference statements)

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“…It is noteworthy that the studies presented small samples and were classified as moderate risk of bias. However, there is increasing interest in the tissue regenerative potential of PRP, several studies worldwide have reported positive results using PRP in chronic ulcers (30)(31)(33)(34) .A non-randomized comparative study published in 2017 evaluated 40 participants with venous ulcers, evaluating the PRP associated with compression therapy for 6 weeks. The PRP group had significant wound area reduction rates (p<0.0001) (34) .…”

Section: Comparison Between Treatment With Growth Factors or Standardmentioning

confidence: 99%

“…According to a study carried out in a public clinic in the Rio de Janeiro State, only 1.5% of patients use compression therapy (47) . A comparative study including 40 participants applied the autologous PRP in the test group and only the compression therapy in the control group, obtaining significant results (p <0.05) favorable to PRP (34) . The application of autologous PRP in the Brazilian context where compression therapy does not present much scope, either due to a lack of material, financial resources or even intolerance by patients, may be a possibility of treatment.…”

Section: Comparison Between Treatment With Growth Factors or Standardmentioning

confidence: 99%

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Treatment of venous ulcers with growth factors: systematic review and meta-analysis

2019

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Objective: To identify evidence about the effects of growth factor application on venous ulcer healing. Method: Systematic review and meta-analysis, including Randomized Clinical Trials. Searches: Ovid MEDLINE, EMBASE, CINAHL, Cochrane CENTRAL, LILACS, Web of Science, Digital Library of Theses and Dissertations; Google Scholar and list of references. Results: 802 participants were recruited from the 10 included studies: 472 in the intervention group (growth factors) and 330 as control. The relative risk for the complete healing outcome was 1.06 [95% CI 0.92-1.22], p = 0.41. Participants who received Platelet-Rich Plasma and Epidermal Growth Factor showed a slight tendency to achieve complete healing, but without statistical relevance (p <0.05). Most of the studies were classified as moderate risk of bias. Conclusion: The effect of the application of growth factors for complete healing in venous ulcers is not clear, and clinical trials with methodological quality are required for more accurate recommendations.

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Section: Comparison Between Treatment With Growth Factors or Standardmentioning

confidence: 99%

Section: Comparison Between Treatment With Growth Factors or Standardmentioning

confidence: 99%

Treatment of venous ulcers with growth factors: systematic review and meta-analysis

2019

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“…Autologous platelet‐rich plasma (PRP) has been used for 30 years in a variety of surgical situations, including blood loss reduction and promotion of tissue regeneration . Although individual small‐scale studies reported an effective use of PRP in VLU management, strong evidence for its effectiveness from high‐quality randomized controlled trials (RCTs) is lacking.…”

Section: Introductionmentioning

confidence: 99%

Adjuvant therapies in venous leg ulcer management: A scoping review

Team

Chandler

Weller

2019

Wound Repair Regeneration

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Compression therapy is the current evidence-based approach to manage venous leg ulcers (VLU); however, adherence is a major barrier to successful treatment. Combination approaches may relieve the burden of treatment by shortening the time to ulcer healing. This scoping review conducted by Australian researchers aimed to establish the evidence of effectiveness of various adjuvant methods on wound healing and recurrence. Randomized Controlled Trials (RCTs), and Systematic Reviews (SR) and Meta-Analyses (MA) on VLU management approaches published from January 2015 to December 2018 were included in this review. The articles included in the scoping review were grouped according to the management approaches, including (1) pharmaceutical interventions, (2) surgical interventions, (3) topical agents, (4) the use of devices, and (5) other, such as physiotherapy and psychological interventions. Results of this scoping review indicate that there is a limited high-quality evidence of effectiveness in most adjuvant therapies on wound healing and recurrence. Given the lowquality evidence observed in this scoping review for adjuvant treatments, the implication for practice is that current management guidelines be followed. Further rigorous studies have the potential to produce better quality evidence. Quality of evidence can be improved by ensuring large sample sizes of a single etiology wounds, standardizing reporting outcomes, and maintaining detailed and evidence-based protocols in physiological or psychological interventions.

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“…Four articles were excluded after reviewing the full text because they involved the treatment of chronic osteomyelitis, pressure ulcers in the trunk, with various anatomical locations or burn injuries. The main characteristics of cell-based and platelet-based studies are summarized Table 1 and Table 2 [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ], respectively.…”

Section: Resultsmentioning

confidence: 99%

Adjuvant Biological Therapies in Chronic Leg Ulcers

Burgos-Alonso

Lobato

Hernández

et al. 2017

IJMS

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Current biological treatments for non-healing wounds aim to address the common deviations in healing mechanisms, mainly inflammation, inadequate angiogenesis and reduced synthesis of extracellular matrix. In this context, regenerative medicine strategies, i.e., platelet rich plasmas and mesenchymal stromal cell products, may form part of adjuvant interventions in an integral patient management. We synthesized the clinical experience on ulcer management using these two categories of biological adjuvants. The results of ten controlled trials that are included in this systematic review favor the use of mesenchymal stromal cell based-adjuvants for impaired wound healing, but the number and quality of studies is moderate-low and are complicated by the diversity of biological products. Regarding platelet-derived products, 18 controlled studies investigated their efficacy in chronic wounds in the lower limb, but the heterogeneity of products and protocols hinders clinically meaningful quantitative synthesis. Most patients were diabetic, emphasizing an unmet medical need in this condition. Overall, there is not sufficient evidence to inform routine care, and further clinical research is necessary to realize the full potential of adjuvant regenerative medicine strategies in the management of chronic leg ulcers.

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Autologous platelet‐rich plasma versus conventional therapy for the treatment of chronic venous leg ulcers: A comparative study

Abstract: Platelet-rich plasma is a safe nonsurgical procedure for treating chronic venous leg ulcers. Additional studies with larger sample size and longer follow-up periods are required to confirm or refute our findings.

Cited by 64 publications

References 16 publications

Treatment of venous ulcers with growth factors: systematic review and meta-analysis

Treatment of venous ulcers with growth factors: systematic review and meta-analysis

Adjuvant therapies in venous leg ulcer management: A scoping review

Adjuvant Biological Therapies in Chronic Leg Ulcers

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