Department of General Medicine, Iran University of Medical Sciences, Tehran, Iran.
Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran.
J Tissue Eng Regen Med. 2022 Oct;16(10):875-899. doi: 10.1002/term.3338. Epub 2022 Jul 6.
Despite the rising trend for applying platelet-rich plasma (PRP) in the management of various types of scars, there is no convincing evidence supporting its use. This motivated us to review the randomized clinical trials that examine the effectiveness and safety of PRP, alone or in combination with other methods, for the management of atrophic or hypertrophic/keloidal scars. The Web of Science, Scopus, Google Scholar, and Cochrane Library databases were systematically searched until September 1 , 2020. Thirteen clinical trials were enrolled in the meta-analysis, and 10 more were reviewed for their results. The random effect meta-analysis method was used to assess the effect size of each outcome for each treatment type, and I was used to calculate the statistical heterogeneity between the studies. Patients treated with PRP experienced an overall response rate of 23%, comparable to the results seen with laser or micro-needling (22% and 23%, respectively) When used alone, moderate improvement was the most frequently observed degree of response with PRP (36%) whereas, when added to laser or micro-needling, most patients experienced marked (33%, 43%, respectively) or excellent (32% and 23%, respectively) results. Concerning the hypertrophic/keloid scars, the only study meeting the required criteria reported a better improvement and fewer adverse effects when PRP was added to the intralesional corticosteroids. Platelet-rich plasma appears to be a safe and effective treatment for various types of atrophic scars. In addition, when added to ablative lasers or micro-needling, it seems to considerably add to the efficacy of treatment and reduce the side effects.
尽管越来越多的人将富血小板血浆 (PRP) 应用于各种类型瘢痕的治疗，但目前仍缺乏令人信服的证据支持其应用。这促使我们对评估 PRP 单独或联合其他方法治疗萎缩性或增生性/瘢痕疙瘩性瘢痕的有效性和安全性的随机临床试验进行了综述。我们系统地检索了 Web of Science、Scopus、Google Scholar 和 Cochrane Library 数据库，检索时间截至 2020 年 9 月 1 日。共有 13 项临床试验被纳入荟萃分析，另外还有 10 项临床试验的结果被纳入综述。采用随机效应荟萃分析方法评估每种治疗类型的每种结局的效应大小，并用 I ² 检验评估研究间的统计学异质性。接受 PRP 治疗的患者总体有效率为 23%，与激光或微针（分别为 22%和 23%）的结果相当。单独使用 PRP 时，最常观察到的反应程度是中度改善（36%），而与激光或微针联合使用时，大多数患者表现出明显改善（33%、43%，分别）或极好改善（32%和 23%，分别）。关于增生性/瘢痕疙瘩，唯一符合要求的研究报告称，当 PRP 联合皮损内皮质类固醇时，改善效果更好，不良反应更少。PRP 似乎是治疗各种类型萎缩性瘢痕的安全有效方法。此外，当联合消融性激光或微针使用时，它似乎能显著提高治疗效果，减少副作用。
