Abstract
Platelet-rich fibrin (PRF) consists of a matrix that provides the necessary elements for wound healing, acting as a biodegradable scaffold for cell migration, proliferation, and differentiation, in addition to the delivery of growth factors and angiogenesis. This study aims to determine the effectiveness of the autologous PRF in the treatment of wounds of different etiologies. We carried out a systematic review of randomized clinical trials, guided by the recommendations of the Cochrane Collaboration using the following databases: Pubmed/MEDLINE, EMBASE, Web of Science, and CENTRAL. The search strategy resulted in the inclusion of ten studies that evaluated the use of PRF dressings for the healing of acute or chronic wounds of multiple etiologies. Among the 172 participants treated with PRF in wounds of varying etiologies and different segment times, 130 presented favorable events with the use of the intervention. Among the 10 studies included, only two of them did not demonstrate better results than the control group. The studies showed clinical heterogeneity, making it impossible to perform a meta-analysis. The findings do not provide enough evidence to support the routine use of PRF dressings as the first line of treatment for the healing of acute or chronic wounds of different etiologies. There was great variability in the application of the various protocols and the ways to prepare the PRF, resulting in clinical heterogeneity. Therefore, it makes it impossible to synthesize and to collect evidence from different types of studies in the meta-analysis, which affects the results and their proper discussion.
Highlights
Human skin is an organ structured by many tissues, designed to develop multiple functions such as thermoregulation, vitamin D metabolization, detection of sensory stimuli, as well as reacting to mechanical trauma, chemical reagents, and pathogens [1,2]
The outcomes provided some evidence to support the routine using platelet-rich fibrin membrane dressings as the first line of treatment to induce the acceleration of wound healing
It seems that the Platelet-rich fibrin (PRF) is not so efficient in the treatment of acute post-surgery wounds as in chronic wounds
Summary
Human skin is an organ structured by many tissues, designed to develop multiple functions such as thermoregulation, vitamin D metabolization, detection of sensory stimuli, as well as reacting to mechanical trauma, chemical reagents, and pathogens [1,2]. Wounds have a huge financial burden on health systems around the world. They account for more than US$ 25 billion per year in the USA, due to the expenses with therapies, which are sometimes ineffective [4]. The establishment of wounds signals to the body the immediate need to correct the lesions through the self-regenerative process known as healing [5]. Wound healing is a physiological process including a cascade of complex, orderly and interconnected events, involving many types of cells interacting in a highly sophisticated temporal sequence, guided by the release of soluble mediators and signals that can influence the direction of the circulating cells to the damaged tissues [6,7]
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