Yammine Kaissar, Ghanimeh Joe, Jil Agopian Sira, Assi Chahine, Hayek Fady
Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Lebanon.
Diabetic Foot Clinic, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon.
Int J Low Extrem Wounds. 2025 Jun;24(2):260-272. doi: 10.1177/15347346221094424. Epub 2022 Apr 14.
Venous leg ulcers (VLUs) are chronic and recalcitrant lower limb wounds that affect millions of patients annually, severely reducing their quality of life, and causing a significant burden on the health care system. Recently, Platelet rich plasma (PRP) has been used to improve healing of VLUs. This systematic review aimed at evaluating the effectiveness of PRP versus the standard of care commonly used to treat VLUs. Ten prospective studies (8 randomized) met the inclusion criteria comprising 451 patients with 527 VLUs. Results were as follows: a) the weighted Odds Ratio (OR) of the mean healing rate was 2.84 (95% CI = 1.160 to 5.056, I = 41.4%, p = 0.0004), b) the mean healed ulcer areas were 79.2 ± 19% for the PRP group and 51.7 ± 36% for the control group (p = 0.007) in favor of the PRP group, and c) the weighted infection OR showed no significant difference between both groups. Additionally, negative correlations were found between healing rate duration of VLUs and initial size of the ulcers. This meta-analysis demonstrated significant beneficial effects of PRP versus standard of care on healing rate, reduction in surface, and reduction in healing time of VLUs. Infection and other complications were similar to standard of care. Therefore, our analytical data would support the use of PRP as a safe and effective treatment for VLUs.
下肢静脉溃疡(VLUs)是一种慢性且难愈合的下肢伤口,每年影响数百万患者,严重降低他们的生活质量,并给医疗保健系统带来沉重负担。最近,富血小板血浆(PRP)已被用于促进VLUs的愈合。本系统评价旨在评估PRP与常用于治疗VLUs的标准治疗方法相比的有效性。十项前瞻性研究(8项随机对照研究)符合纳入标准,共纳入451例患者的527个VLUs。结果如下:a)平均愈合率的加权比值比(OR)为2.84(95%置信区间=1.160至5.056,I=41.4%,p=0.0004),b)PRP组平均愈合溃疡面积为79.2±19%,对照组为51.7±36%(p=0.007),PRP组更优,c)加权感染OR显示两组之间无显著差异。此外,还发现愈合率与VLUs持续时间和溃疡初始大小之间存在负相关。这项荟萃分析表明,与标准治疗相比,PRP在VLUs的愈合率、溃疡面积缩小和愈合时间缩短方面具有显著的有益效果。感染和其他并发症与标准治疗相似。因此,我们的分析数据支持将PRP作为一种安全有效的VLUs治疗方法。