Kao Yu-Chien, Lin Dai-Zhu, Lee Sheng-Lian, Chen Chiehfeng, Wang Hsian-Jenn, Chiu Wen-Kuan
School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan.
Burns. 2021 Aug;47(5):1012-1023. doi: 10.1016/j.burns.2020.11.005. Epub 2020 Dec 24.
Platelet-rich plasma (PRP) therapy has been used in different medical fields, but its effectiveness in burn wound healing remains debatable. In this study, we performed a systematic review and meta-analysis of the available evidence on burn patients treated with PRP to evaluate the safety and efficacy of the treatment.
Randomized controlled trials evaluating the efficacy of PRP in patients with burn injuries were selected. Eligible retrospective studies were abstracted and assessed for the risk of bias by two reviewers and results of mean time to complete epithelization and wound closure rate in the included studies were analyzed. Studies on the correlation between PRP and burn wound healing published in English or Chinese before March 2020 were retrieved from PubMed.
Eight studies (including 449 patients) met our inclusion criteria. Qualitative analysis revealed that compared with the control group, the PRP group had significantly better wound closure rates at weeks 2 (mean difference (MD): 12.79 [95% confidence interval (CI): 7.08, 18.49]; I2: 0%; p < 0.0001) and 3 (MD: 12.66 [95% CI: 5.97, 19.34]; I2: 55%; p = 0.0002) and time to complete epithelialization (MD: -3.45 [95% CI: -4.87, -2.04] (days); I2: 0%; p < 0.00001). There was no significant difference in infection rate or graft take rate.
PRP application can accelerate wound closure, however, it has no effect on the rates of wound infection and graft take rate.
富血小板血浆(PRP)疗法已应用于不同医学领域,但其在烧伤创面愈合中的有效性仍存在争议。在本研究中,我们对有关PRP治疗烧伤患者的现有证据进行了系统评价和荟萃分析,以评估该治疗方法的安全性和有效性。
选取评估PRP对烧伤患者疗效的随机对照试验。由两名评价者提取符合条件的回顾性研究并评估其偏倚风险,分析纳入研究中创面完全上皮化的平均时间和创面愈合率的结果。从PubMed检索2020年3月之前发表的英文或中文关于PRP与烧伤创面愈合相关性的研究。
八项研究(包括449例患者)符合我们的纳入标准。定性分析显示,与对照组相比,PRP组在第2周(平均差(MD):12.79 [95%置信区间(CI):7.08,18.49];I²:0%;p < 0.0001)和第3周(MD:12.66 [95%CI:5.97,19.34];I²:55%;p = 0.0002)的创面愈合率显著更高,且创面完全上皮化的时间更短(MD:-3.45 [95%CI:-4.87,-2.04](天);I²:0%;p < 0.00001)。感染率或植皮成活率无显著差异。
应用PRP可加速创面愈合,然而,其对创面感染率和植皮成活率无影响。