Xiao Hong, Xu Dan, Mao Rui, Xiao Minqin, Fang Yang, Liu Yin
Department of Plastic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People's Republic of China.
Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People's Republic of China.
Clin Cosmet Investig Dermatol. 2021 Nov 16;14:1697-1724. doi: 10.2147/CCID.S340434. eCollection 2021.
Platelet-rich plasma (PRP) is a promising noninvasive technique for facial rejuvenation. This systematic literature review aims to appraise the nature and quality of published evidence evaluating the effectiveness and safety of PRP in facial rejuvenation.
A systematic literature review was conducted with the search string "Platelet-rich plasma AND Facial rejuvenation" in PubMed and Embase. Clinical studies evaluating the outcomes after PRP-based facial rejuvenation either as monotherapy or in combination with other treatment modalities were included. Studies evaluating wound-healing properties of PRP were excluded. The outcomes included both patient-reported and physician-assessed outcomes. Nonstatistical synthesis of evidence was performed by qualitative assessment. The results are reported by the Synthesis Without Meta-analysis (SWiM) reporting standard.
A total of 36 studies that included a total of 3172 patients were considered for the evidence synthesis. The number of patients in the included studies ranging from 11 to 2005 with a median of 27.5 patients that reflects the challenges in clinically assessing the aesthetic outcomes after PRP-based facial rejuvenation. Among the 36 studies, 17 were observational studies and 18 were interventional studies with 1 being case report PRP was evaluated either alone or in combination with hyaluronic acid, lipofilling, micro-needling technique, and laser-based interventions. Among the studies, 1 study reported the enhanced platelet concentrate in a fibrin matrix to be relatively safe and effective with a maximum benefit observed at 12 weeks suggesting the platelet-rich fibrin matrix may provide desired aesthetic outcomes and it requires further studies to substantiate.
The results suggest very limited clinical evidence, and further clinical studies are warranted to establish the effectiveness of PRP in facial rejuvenation. Furthermore, a consensus for end points used for establishing clinical utility in patients requiring facial rejuvenation is warranted.
富血小板血浆（PRP）是一种很有前景的面部年轻化非侵入性技术。本系统文献综述旨在评估已发表证据的性质和质量，以评价PRP在面部年轻化中的有效性和安全性。
在PubMed和Embase中使用检索词“富血小板血浆与面部年轻化”进行系统文献综述。纳入评估基于PRP的面部年轻化作为单一疗法或与其他治疗方式联合使用后的结果的临床研究。排除评估PRP伤口愈合特性的研究。结果包括患者报告的结果和医生评估的结果。通过定性评估进行证据的非统计性综合。结果按照非荟萃分析综合（SWiM）报告标准进行报告。
共有36项研究纳入证据综合分析，这些研究共涉及3172例患者。纳入研究中的患者数量从11例到2005例不等，中位数为27.5例患者，这反映了在临床评估基于PRP的面部年轻化后的美学效果方面存在挑战。在这36项研究中，17项为观察性研究，18项为干预性研究，1项为病例报告。PRP单独或与透明质酸、脂肪填充、微针技术和基于激光的干预措施联合进行评估。在这些研究中，1项研究报告纤维蛋白基质中增强的血小板浓缩物相对安全有效，在12周时观察到最大益处，提示富血小板纤维蛋白基质可能提供理想的美学效果，这需要进一步研究加以证实。
结果表明临床证据非常有限，有必要进行进一步的临床研究以确定PRP在面部年轻化中的有效性。此外，对于在需要面部年轻化的患者中确立临床效用所使用的终点达成共识是必要的。
