Effect of platelet‐rich plasma vs standard management for the treatment of diabetic foot ulcer wounds: A meta‐analysis

Gong, Fan; Zhang, Yun; Gao, Jian; Li, Xiaoliang; Zhang, Hanlin; Ma, Guoxu; Huang, Yonglu; Zhang, Bowen; Zhao, Fei

doi:10.1111/iwj.13858

Cited by 7 publications

(5 citation statements)

References 53 publications

(112 reference statements)

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“…Additionally, ulcer healing following these treatments is reported to be poor and time‐consuming 11 . Hence, several adjuvant approaches have been recently investigated for the treatment of DFU, such as human amniotic membrane allograft, 12 recombinant human epidermal growth factor, 13 laser therapy, 14 platelet‐rich plasma, 15 hyperbaric oxygen therapy 16 and modern dressings 17 . However, the use of these adjuvant treatments is not without concerns, and the best strategies for the healing of DFU continue to be a challenge 18 .…”

Section: Introductionmentioning

confidence: 99%

Healing of diabetic foot ulcer with topical and oral administrations of herbal products: A systematic review and meta‐analysis of randomized controlled trials

Zamanifard,

Nasiri,

Yarahmadi

et al. 2024

International Wound Journal

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This systematic review aimed to qualitatively synthesize recent randomized controlled trials (RCTs) regarding the effect of topical application and oral intake of herbal products on the healing of diabetic foot ulcer (DFU). Also, we sought to pool the obtained findings in a meta‐analysis using a random‐effects model, if RCTs were relatively comparable and homogenous. A comprehensive search was performed on five electronic data sources from their inception through 23 January 2024. The RCTs, without restriction on the country of origin, were included if they compared the effect of administering standard treatments and/or placebo (i.e. control condition) to applying standard treatments and/or herbal products in topical or oral routes (i.e. experimental condition). Out of 1166 retrieved records, 28 RCTs were included. Studies used different poly and single herbal formulations. Based on the meta‐analysis, administration of standard care plus daily dressing of the ulcer site with olive oil for 28 days significantly increased the total ulcer healing score (3 RCTs; weighted mean difference [WMD] = 89.30; p < 0.001), raised frequency of complete ulcer healing (2 RCTs; risk ratio [RR] = 12.44; p = 0.039) and declined ulcer degree (3 RCTs; WMD = −22.28; p = 0.002). Also, daily use of the bitter melon leaf extract in oral form for 28 days significantly increased the total ulcer healing score (2 RCTs; WMD = 0.40; p = 0.001). Additionally, based on qualitative synthesis, the adjuvant use of herbal agents seems an intriguing choice to manage DFU. Nonetheless, considering the undesirable methodological quality of most studies and the high heterogeneity in administered herbal formulations, more robust trials are required to build a solid conclusion regarding the use of herbal products for healing DFU.

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Section: Introductionmentioning

confidence: 99%

Healing of diabetic foot ulcer with topical and oral administrations of herbal products: A systematic review and meta‐analysis of randomized controlled trials

Zamanifard,

Nasiri,

Yarahmadi

et al. 2024

International Wound Journal

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“…The progression of foot ulcer ulcers is caused by neuropathy, peripheral artery disease, foot abnormalities, and undiagnosed mild injuries. Since the foot ulcer is a conduit for infection that frequently results in limb amputation in individuals, healing must be completed very quickly after the foot ulcer lesion manifests [8] .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Platelets Rich Plasma as A Therapeutic Tool in Chronic Non-Healing Diabetic Foot Ulcers

Khalifa¹,

Abuelrus²,

Abdelmohsen³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: One of the most prevalent and serious consequences in people with diabetes mellitus is diabetic foot ulcer (DFU). High management complexity, morbidity, and mortality are its defining traits. More efficient treatment methods are required since DFU therapy is still seen as frustrating and unsatisfying, even though new treatment alternatives are being developed. Objective: To assess the efficacy of using of platelet-rich plasma (PRP) on healing of DFUs in comparison to conventional therapy. Method: A randomized controlled clinical trial was conducted on 92 diabetic patients with DFUs. Those patients were randomly divided into two equal groups either study group in which PRP was used and applied locally to the wound followed by Vaseline gauze and sterile dressing, and control group where patients received standard therapy in form of debridement and dressing. Patients were seen twice weekly throughout the treatment course and clinical evaluation was performed once weekly. Results: Both groups had insignificant differences as regard basic characteristics and laboratory data. Study group showed significant higher frequency of complete wound healing in comparison to the control group (73.8% vs. 30.4%; p<0.001). Percentage of wound reduction in the size of the ulcer at the end of the study in comparison to baseline size was significantly better in the study group. Mean time to complete healing was significantly lower among study group in comparison to the control group (8.15 ± 0.37 vs. 11.30 ± 0.17 (week); p<0.001). Conclusion: Autologous PRP significantly improved the complete ulcer healing in patients with DFUs. Well designed and adequately powered clinical trials are needed to confirm these findings.

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“…In recombinant human growth factor-based therapies, platelet-rich plasma (PRP) is effective in promoting wound healing by increasing the level of growth factors in the wound of DFU patients. 9,10 Although PRP and stem cells act similarly in DFU treatment, their efficacies and underlying mechanisms are possibly different. Publications exploring the therapeutic effects of each method are often found in literature review, 11,12 and those comparing the therapeutic effects of the two treatments, however, have been rarely reported.…”

Section: Introductionmentioning

confidence: 99%

“…For instance, gel prepared with umbilical cord mesenchymal stem cells (UC‐MSCs) can promote the healing, improve the blood supply and reduce inflammatory responses of the wound. In recombinant human growth factor‐based therapies, platelet‐rich plasma (PRP) is effective in promoting wound healing by increasing the level of growth factors in the wound of DFU patients 9,10 …”

Section: Introductionmentioning

confidence: 99%

Comparative study on the efficacy of PRP gel and UC‐MSCs gel as adjuvant therapies in the treatment of DFU wounds

Jin,

Meng,

Zhang

et al. 2024

Skin Research and Technology

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BackgroundDiabetic foot ulcer (DFU) is a common and serious complication of diabetes, and its treatment is challenging. Platelet‐rich plasma (PRP) gel and umbilical cord mesenchymal stem cells (UC‐MSCs) gel have been concerned as new therapies for DFU in recent years, and comparative studies on the efficacy and mechanisms of these methods, however, are rarely reported.MethodsThirty patients with DFU were selected and divided into the PRP group and the UC‐MSCs group, and wound healing, foot blood vessels (ABI index), infection index (CRP), neuropathy symptoms (TCSS score), and foot skin temperature before and after treatment were compared between the two groups. SPSS 21.0 was used for statistical analysis.ResultsThe results showed that the efficacy of the UC‐MSCs gel group was significantly better than that of the PRP group in terms of wound healing rate, time to complete wound closure, ABI index, CRP level and TCSS score. No statistically significant difference in foot skin temperature was observed between the two groups.ConclusionThe efficacy of UC‐MSCs gel is significantly superior to that of PRP gel in the treatment of DFU, with shortened time to complete wound closure, increased wound healing rate, better pain and infection control, and improved vascular and neurological symptoms.

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Effect of platelet‐rich plasma vs standard management for the treatment of diabetic foot ulcer wounds: A meta‐analysis

Cited by 7 publications

References 53 publications

Healing of diabetic foot ulcer with topical and oral administrations of herbal products: A systematic review and meta‐analysis of randomized controlled trials

Healing of diabetic foot ulcer with topical and oral administrations of herbal products: A systematic review and meta‐analysis of randomized controlled trials

Efficacy of Platelets Rich Plasma as A Therapeutic Tool in Chronic Non-Healing Diabetic Foot Ulcers

Comparative study on the efficacy of PRP gel and UC‐MSCs gel as adjuvant therapies in the treatment of DFU wounds

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