Effects of platelet‐rich plasma on the healing of sternal wounds: A meta‐analysis

Abstract

Sternal wound infection (SWI) is a devastating complication after cardiac surgery. Platelet‐rich plasma (PRP) may have a positive impact on sternal wound healing. A systematic review with meta‐analyses was performed to evaluate the clinical effectiveness of topical application of autologous PRP for preventing SWI and promoting sternal wound healing compared to placebo or standard treatment without PRP. Relevant studies published in English or Chinese were retrieved from the Cochrane Central Register of Controlled Trials (The Cochrane Library), PubMed, Ovid EMBASE, Web of Science, Springer Link, and the WHO International Clinical Trials Registry Platform (ICTRP) using the search terms “platelet‐rich plasma” and “sternal wound” or “thoracic incision.” References identified through the electronic search were screened, the data were extracted, and the methodological quality of the included studies was assessed. The meta‐analysis was performed for the following outcomes: incidence of SWI, incidence of deep sternal wound infection (DSWI), postoperative blood loss (PBL), and other risk factors. In the systematic review, totally 10 comparable studies were identified, involving 7879 patients. The meta‐analysis for the subgroup of retrospective cohort studies (RSCs) showed that the incidence of SWI and DSWI in patients treated with PRP was significantly lower than that in patients without PRP treatment. However, for the subgroup of randomized controlled trials (RCTs), there was no significant difference in the incidence of SWI or DSWI after intervention between the PRP and control groups. There was no significant difference in PBL in both RCTs and RSCs subgroups. Neither adverse reactions nor in‐situ recurrences were reported. According to the results, PRP could be considered as a candidate treatment to prevent SWI and DSWI. However, the quality of the evidence is too weak, and high‐quality RCTs are needed to assess its efficacy on preventing SWI and DSWI.

A study on the preoperative risk factors for primary healing failure in the reconstruction of deep sternal wound infection with platelet‐rich plasma and negative pressure trauma therapy

“…The platelet-rich plasma (PRP) plus NPWT treatment (PRP + NPWT) is a relatively new and effective modality to treat chronic, difficult-to-heal wounds and tissue defects in recent years. [5][6][7] The authors' department also confirmed in their previous studies that this treatment modality was highly effective in treating DSWI patients, with a significant advantage over the NPWT performed alone. 8 PRP contains a small amount of plasma liquid, a few or no leukocytes, and PLTs that are higher than the average normal concentration in our blood (3 $ 10 times the normal baseline).…”

Preliminary report of intraovarian injections of autologous platelet-rich plasma (PRP) in extremely poor prognosis patients with only oocyte donation as alternative: a prospective cohort study

“…PRP use was initiated in sports medicine in the 1970s ( Peerbooms et al ., 2010 ; Thanasas et al ., 2011 ) and has since expanded into many medical specialty fields: to regenerate skin ( Fabi and Sundaram, 2014 ) and cartilage ( Xie et al ., 2014 ), to treat autoimmune conditions ( Lippross et al ., 2011 ; Tong et al ., 2017 ) and even to treat hair loss ( Gentile and Garcovich, 2020 ). In most medical disciplines, the efficacy of PRP is, however, still under debate ( Wolf et al ., 2011 ; Cai et al ., 2020 ; Guida et al ., 2020 ; Zhao et al ., 2020 ; Atkinson et al ., 2021 ; Yao et al ., 2021 ).…”

Serum Levels of VWF, t-PA, TNF-α, and ICAM-1 in Patients Receiving Hemocoagulase Combined with Platelet-Rich Plasma during Total Hip Replacement

“…It has been widely used in various operations, such as hair restoration [ 6 ], hip and knee osteoarthritis [ 7 ], and facial plastic surgery [ 8 ]. Enormous studies have proven that PRP contributed to reduction in blood loss and allogeneic blood transfusion [ 9 , 10 ] and enhancement on wound healing [ 11 ]. In addition, PRP application in liver and spinal surgery can improve intraoperative coagulation disorders caused by autologous blood reinfusion, blood dilution, and the application of plasma substitutes [ 12 ].…”