Efficacy Of Autologous Platelet-rich Plasma Research Articles

(112) Efficacy and Safety of Platelet-Rich Plasma Injections for Peyronie’s Disease: A Randomized Double-Blind Placebo-Controlled Cross-Over Study

Abstract Introduction Peyronie's Disease (PD) is currently treated with intralesional collagenase injection, the only FDA-approved medical therapy. Platelet-derived therapies, such as autologous platelet rich plasma (PRP), have shown potential in tissue regeneration. We are investigating the safety and efficacy of PRP in PD with an ongoing randomized, placebo-controlled, crossover study. Objective The objective of this study is to assess the safety and efficacy of autologous platelet-rich plasma (PRP) treatment in Peyronie's Disease (PD) through a randomized, placebo-controlled, crossover trial. Methods We analyzed data from an ongoing trial conducted between April 2021 and June 2023. Men with PD (write degrees/dorsal only etc) were randomly assigned to receive two 0.5 ml injections of PRP obtained using an autologous platelet separator (Arthrex Angel, Arthrex Inc.) or placebo directly into the dominant plaque, with a two-week interval between injections. Immediate post-procedure assessments included Visual Analogue Pain Scale, and follow-up evaluations focused on identifying complications. After three months, participants crossed over to the other treatment arm for two additional injections. Goniometer measurement assessments were performed prior to each crossover (NCT04512287). Related Samples Wilcoxon-Signed Rank test was used for dependent repeated groups, the serial measurements of degree of curvature at different time points for each patient within a specific group. Findings at p< 0.05 were considered statistically significant. Results The analysis includes data from 29 men who completed all injections and the 6-month follow-up. No minor or major adverse events, such as penile bruising, swelling, edema, allergy, or penile fracture, were reported. Regarding efficacy, we observed a significant reduction in curvature after six months compared to baseline. The pretreatment median curvature was 40.0 (IQR: 15), the median post-treatment curvature 30.0 (IQR: 30) (p=0.014). Furthermore, we did not observe worsening of curvature in subsequent evaluations. Conclusions Our findings from our ongoing clinical trial suggest that PRP treatment for Peyronie's Disease is safe, with minimal adverse events reported. The preliminary efficacy data indicates a significant reduction in curvature after 2 injections each of placebo and PRP treatment compared to baseline. Nevertheless, study completion is necessary prior to reporting true efficacy data comparing PRP vs placebo. Disclosure No.

A Comparison of Efficacy of Autologous Platelet-rich Plasma and Conventional Sutures in Anchoring Split Skin Graft on Wounds

Abstract Context: Split thickness skin grafting (STSG) restores cutaneous cover over wounds thus protecting the underlying surface from contamination, fluid loss and stimulates healing. Autologous platelet rich plasma (PRP) provides a large number of platelets and high concentration of growth factors which promote overall uptake of STSG. Aims: The aim of this study was to assess the immediate, subsequent adhesion and final take of STSG with application of PRP over recipient site. Methods and Material: 1 year Randomised Control Trial where 80 wounds of various aetiologies were randomised into intervention group (n=40) which received PRP before placing STSG on recipient site and control group (n=40) in which the graft was fixed in place with sutures alone. Immediate graft adhesion and subsequent graft uptake were compared between the two groups and statistical analysis was done with: SPSS Version 20. Results: Irrespective of aetiology, and size, among a total of 80 wounds 87.5% grafts had adhered by 1st minute of application in the intervention group compared to nil in control group (p< 0.0001). Graft uptake was assessed on first three consecutive dressings. There was significantly better graft uptake in intervention group compared to control group [third dressing uptake (98.29%, 93%, p< 0.0001) respectively].Difference in seroma and haematoma formation were also compared between the two groups and found to be not significant. (p>0.05) Conclusions: Application of topical PRP facilitates STSG uptake. It decreases operative time by decreasing mobility of graft over the wound bed. Thus, use of PRP improves outcome of split thickness skin graft in wounds of various aetiologies and we recommend use of the same at recipient site of STSG. CTRI/2021/06/034401

Electrophysiological and Visual Parameter Changes in Retinitis Pigmentosa Patients undergoing Autologous Platelet-Rich Plasma Therapy: A Randomized Control Trial.

To assess the efficacy of autologous platelet-rich plasma (PRP) injections in suprachoroidal space and subtenon space in cases of retinitis pigmentosa, which is a genetic disease, leading to gradual loss of vision. Till date, no treatment is available. Seventy-eight eyes of 39 patients of retinitis pigmentosa having visual acuity ranging from reading of Early Treatment Diabetic Retinopathy Study (ETDRS) chart from 1 m onward to patients who were not able to read the ETDRS chart but whose visual acuity ranged from finger count close to face to <1 m were included in the study. The left and right eyes of each patient were randomized as the intervention eye and control eye. 0.2 mL of autologous PRP was injected in suprachoroidal space and 0.5 mL of PRP was injected in subtenon space of the intervention eye taking aseptic precautions. Injections were repeated at 15-day intervals up to 3 injections. Majority of patients were in the age group of 18-30 years (20 cases) followed by 31-45 years (13 cases) and more than 45 years (6 cases). Intervention eyes showed a statistically significant improvement in visual acuity and multifocal electroretinography (mfERG). Improvement was noted in amplitude density latency and in ring ratio of mfERG. There was a significant improvement in best-corrected visual acuity (BCVA). However, no improvement in mfERG or BCVA was observed in the control group. Gene therapy may be the ultimate cure for retinitis pigmentosa, but it is unaffordable for many patients due to its high cost. PRP may be recognized as a modality to improve vision and stop further deterioration, especially in cases where functional vision is preserved. Negligible treatment costs and affordability will give power to economically disadvantaged patients.

Efficacy of autologous platelet-rich plasma combined with a non-cross-linked hyaluronic acid compound in the treatment of female androgenetic alopecia: A retrospective, case-series study.

Female androgenetic alopecia (FAGA) is a condition that affects women and involves the gradual loss of terminal hair in specific areas of the scalp. The limited treatment options for FAGA necessitate the development of new strategies. This study aimed to evaluate the potential benefit of using a combination therapy composed of autologous platelet-rich plasma (PRP) and a non-cross-linked hyaluronic acid (HA) compound in the treatment of FAGA. This was a retrospective, case-series study, which enrolled nine female patients with FAGA between September 2021 and December 2022. The non-cross-linked HA compound (Hearty®, Imeik Technology Development Co., Ltd.) and PRP were implanted into the areas of hair loss over four treatment sessions separated by 4-week intervals. Patients were monitored for overall improvement in their hair loss, hair count, treatment satisfaction, and adverse events at 1, 3, and 6 months follow-up. The improvement rates, subjectively evaluated by the study physician, were 88.89% at the 1-month and 100% at the 3-month follow-up, relative to baseline. Moreover, the quantitative evaluation results showed that the FAGA patients' hair density increased by 54.51% at the 1-month and by 77.25% at the 3-month follow-up. The combination of PRP and non-cross-linked HA compound appeared to be a certain positive effective procedure for FAGA without serious adverse event. We envisage that this work will contribute to the development of new treatment options for women suffering from this condition.

Allogenic platelet-rich plasma for treatment of knee and hip osteoarthritis.

Osteoarthritis (OA) induces tremendous amounts of stress and financial burden on patients and healthcare systems worldwide. Current treatments have limitations and do not address the etiopathogenetic cause of OA. Regenerative medicine may circumvent limitations posed by traditional modalities and relies on the utilization of biologics including platelet-rich plasma (PRP). Several peer-reviewed studies have documented the safety and efficacy of autologous PRP in mitigating symptoms in knee and hip OA patients. Nonetheless, only few studies investigated the safety and efficacy of allogenic PRP. This mini review summarizes the outcomes of preclinical and clinical studies using allogenic PRP for treatment of knee or hip OA. We identified 3 preclinical and 1 clinical study using allogenic PRP for treatment of knee OA, and only 1 clinical study using allogenic PRP for treatment of hip OA. Administration of allogenic PRP is safe and probably efficacious in patients with knee or hip OA. However, more pre-clinical studies and high-powered, multi-center, non-randomized and randomized controlled trials with extended follow-up are warranted to further establish the safety and efficacy of allogenic PRP to justify its clinical use.

A Comparative Study on Therapeutic Efficacy of Autologous Platelet-rich Plasma, Autologous Platelet-rich Fibrin Matrix, Recombinant Human Epidermal Growth Factor, and Collagen Particles in Nonhealing Leg Ulcers.

Nonhealing leg ulcers are challenging to manage and cause significant patient morbidity. To promote healing, newer techniques focus on delivering/enhancing dermal matrix components. The aim of this study was to compare the therapeutic efficacy of autologous platelet-rich plasma (PRP), autologous platelet-rich fibrin matrix (PRFM), recombinant human epidermal growth factor (rhEGF), and collagen particles in treating nonhealing leg ulcers. Open, randomized prospective study was conducted in a single tertiary center over 2 years where after fulfilling the criteria, randomization was done into four groups. Group A: Autologous PRP (double spin, manual method, weekly); Group B: Autologous PRFM (weekly); Group C: rhEGF (daily application); and Group D: Collagen particles (weekly) along with cleansing, debris removal, and wound dressing. Treatment endpoints were complete healing/6 months of treatment, whichever was earlier. Follow-up was done two weekly by clinical assessment, photographs, and measurement of the ulcer area. Epi info 7 software was used for statistical analysis. A total of 48 patients completed the study, 12 in each group, with mean age: 42.37 ± 4.56 years and male-to-female ratio 2.6:1. Underlying etiology was varicosities (43.75%), traumatic (25%), diabetes (22.91%), and leprosy (8.34%). At baseline, all groups were comparable in terms of patient and ulcer characteristics. Complete healing was seen in 79.17% at the end of 12 weeks: 91.67% of patients from Groups A and B each, and 66.67% from Groups C and D each. The mean time to complete healing was 6.9 ± 2.5 weeks, the least in Group B (4.73 ± 2.3 weeks). Differences between excellent (≥75%) ulcer healing across all groups were statistically significant at the end of 8 weeks where Group B showed maximum improvement. No major adverse events were seen. PRFM resulted in relatively faster ulcer healing compared with other modalities.

Efficacy of autologous platelet-rich plasma in the treatment of dormant corneal ulcer

Objective The aim of this study was to compare the clinical efficacy of platelet-rich plasma (PRP) eye drops to conventional therapy (preservative-free artificial tears and vitamin A gel drops) in the management of dormant corneal ulcer. Patients and methods This prospective study was conducted on 50 eyes of 50 patients with dormant corneal ulcer. The patients were randomized into two equal groups: group I, treated with PRP eye drops plus conventional therapy, and group II, treated with conventional therapy only. Corrected distance visual acuity, healing of corneal surface, and subjective symptoms were evaluated. Results There was a statistically highly significant difference between the pretreatment and the 3-month posttreatment ulcer size in the PRP group (3.76±1.33 and 0.92±1.96 mm, respectively, P&lt;0.001) as well as in the conventional group (4.12±0.97 and 2.72±2.28 mm, respectively, P=0.005). There was a statistically significant difference between the two groups regarding the degree of healing, favoring the PRP group (P=0.004), as clinical improvement was evident in 22 (88%) eyes in group I of which 18 (72%) eyes showed complete response and four (16%) eyes showed partial response, whereas in group II, clinical improvement was evident in 12 (48%) eyes, of which seven (28%) eyes showed complete response and five (20%) eyes showed partial response. There was a nonsignificant difference between the two groups regarding the pretreatment ulcer size (P=0.26). However, there was a significant difference between the two groups after 3 months regarding the ulcer size, the difference in ulcer size compared with the pretreatment size, and the symptom improvement, favoring the PRP group (P=0.002, 0.02, and 0.002, respectively). However, there was a nonsignificant difference between the two groups regarding the visual improvement (P=0.076). There were no complications related to the treatment in both groups. Conclusions Autologous PRP seems to be an effective treatment for dormant corneal ulcers with better healing outcomes when compared with the conventional treatment.

Efficacy of autologous platelet-rich plasma for long-term glucocorticoids caused chronic wound: a case report.

The repair of bone explore wounds is one of the difficult problems in plastic and reconstruction surgery. Platelet-richplasma(PRP) isasafe and efficient therapeutic optionfor various trauma, including Osteoarticular, musculoskeletal, and Wound injuries. However, the preparation and storage of PRP becomes challenging for patients with poor systemic status and requiring multi-use of PRP. The availability of safe, reliable tissue bank makes it possible. We report a case of a 42-year-old woman patient with a chronic hip wound combined with ischium bone exploration. And the patient who was treated with long-term glucocorticoids for rheumatoid arthritis has been through the experience of extensive conservative management. Thereafter necrosectomy and Vacuum-Assisted Closure (VAC) surgical procedure failed, and aPRPdaily injectionwas performed at the ischial muscle and soft tissue. Neo-muscle appeared around the explored ischium bone after 8weeks of injection and Complete wound healing was obtained in 3months.

Comparison of the Efficacy of Autologous Platelet-Rich Plasma and Saline Dressing in Healing of Diabetic Foot UlcerA Randomised Control Study

Introduction: According to research by the World Health Organisation (WHO), there are 347 million diabetics worldwide, and by 2030, it will overtake smoking as the seventh leading cause of death and diabetic people have a lifetime risk of up to 25% for developing a foot ulcer. Many novel techniques are emerging to fasten wound healing, including cellular therapies using PlateletRich Plasma (PRP) and collagen-based dressings. Aim: To compare the efficacy between instillation of autologous PRP and conventional dressing using normal saline/povidone iodine in Diabetic Foot Ulcers (DFU). Materials and Methods: This randomised control clinical study was conducted in the Department of General Surgery at SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India. The duration of the study was 18 months, from April 2021- September 2022. A total of 174 DFU patients were included in the study, meeting inclusion and exclusion criteria’s. Patients were divided into case (n=87) and control group (n=87). For six weeks, the case group got autologous PRP, while the control groups regularly had standard dressings. Wound areas were measured using ruler scale weekly and percentage of healing was monitored for 12 weeks. The data were analysed with International Business Machines (IBM)- Statistical Package for Social Sciences (SPSS) version 21.0. Results: In a group of 87 each, 174 patients with chronic non healing DFUs were randomly assigned to the study group (PRP) or the control group (conventional dressing method) throughout the 9 months study. Age ranged from less than 40 years to more than 61 years in the present study of 174 patients, with the age group between 51 and 60 years having the highest percentage of patients (50.6%), followed by the age group over 61 years (23.6%). About 12 weeks after the treatment, it was discovered that, the case group had a 86% reduction in wound area of 86.51±15.71 mm, whereas, the control group had a 61% reduction in wound area of 65.47±30.18 mm and 65.1% of patients from the case group showed wound healing, while 42.7% of patients from the control group showed wound healing. These findings were found to be statistically significant (p-value &lt;0.001). Conclusion: The use of PRP led to a higher rate of wound healing in less time when compared to traditional wound care in the therapy of chronic DFUs, as shown in the present study. For chronic DFUs, PRP was able to speed up healing, making it a potentially viable and promising treatment

Efficacy of autologous platelet-rich plasma in preventing adhesion reformation following hysteroscopic adhesiolysis: a randomized controlled trial

Research questionWhat is the efficacy of platelet-rich plasma (PRP) in reducing adhesion reformation in women with moderate to severe intrauterine adhesions (IUA)? DesignIn this randomized controlled trial, women with moderate-to-severe IUA were recruited between November 2019 and June 2021 from a university hospital and randomized into the PRP or control group. The PRP group was treated using an intrauterine-suitable balloon combined with PRP infusion following hysteroscopic adhesiolysis, whereas the control group received only the former intervention. The reductions in adhesion scores from before to after surgery and the adhesion reformation rate were analysed. ResultsA total of 123 participants successfully completed the study (PRP group, 63; control group, 60). Age, pregnancy history, menstrual score and American Fertility Society score before surgery were not significantly different between the two groups. At the second-look hysteroscopy, the PRP group had a significantly greater reduction in adhesion score than the control group (7 versus 6, respectively; P = 0.027). The postoperative adhesion reformation rates in the PRP group and the control group were 20.6% and 30.0%, respectively (risk ratio 0.69, 95% confidence interval 0.27–1.38, P = 0.232; number needed to treat 10.6). ConclusionsIntrauterine PRP infusion seems to be beneficial in reducing postoperative adhesion reformation following hysteroscopic adhesiolysis.

Autologous platelet-rich plasma eye drop versus artificial tear eye drop for symptomatic dry eye disease: A prospective comparative interventional study.

Purpose:To evaluate and compare the efficacy of autologous platelet-rich plasma (aPRP) eye drop and artificial tear (AT) eye drop in moderate to severe symptomatic dry eye disease (DED).Methods:This prospective interventional study included 121 eyes of 61 patients of moderate to severe DED. Patients were divided into aPRP (31 patients) and AT (30 patients) group. Ocular Surface Disease Index (OSDI) score, tear film breakup time (TBUT) (s), corneal fluorescein staining (CFS) score, and Schirmer test score (mm) of both the groups were evaluated and compared pre-treatment and post-treatment at the end of 3 months.Results:The mean age of the aPRP group and AT group was 52.8 ± 12.8 years and 55.5 ± 13.4 years, respectively. At the end of 3 months, OSDI score reduced more in the aPRP group as compared to AT group, and the mean difference (−22.7) was statistically significant (P < 0.001). There was no significant difference in post-treatment Schirmer test score between the two groups (P = 0.44). Post-treatment improvement in TBUT and CFS score in the aPRP group was significantly higher in the aPRP group as compared to that in the AT group (P < 0.05). Bruising at the site of blood withdrawal was noted in two patients in the aPRP group.Conclusion:aPRP is safe and more effective than AT in treating patients with moderate to severe symptomatic DED.

A clinical study on efficacy of peri-lesional autologous platelet-rich plasma in non-healing ulcers

Background: Non-healing ulcers are a major health problem worldwide and have a great impact at personal, professional, and social levels. They are a major cause of non-traumatic lower limb amputations. The application of autologous Platelet Rich Plasma (PRP) has been a breakthrough in the treatment of non-healing ulcers, as it is an easy and cost-effective procedure, and provides the necessary growth factors that enhance tissue healing. The aim and objective of the study was to test the effectiveness of peri-ulcer autologous platelet-rich plasma injection in chronic non-healing ulcers and to assess the time taken for wound closure.Methods: This study was conducted on 50 patients during the period of November 2020 to October 2021 from the in-patients of the surgical unit in Dr. PSIMS and RF. Autologous PRP was prepared from whole blood utilizing a rapid, point-of-care system that works on the principle of density gradient centrifugation. Fifty (50) patients with non-healing ulcers of different etiologies, who met the inclusion criteria, were treated with peri-ulcer autologous PRP injections once weekly.Results: Of the 50 cases 29 were male and 21 were female, the mean age of the patients is 54.48±10.79 years. All the patients showed signs of wound healing with a reduction in wound size, and the mean time duration of ulcer healing was 6.75±1.47 weeks.Conclusions: This prospective study has demonstrated the potential safety and efficacy of autologous platelet-rich plasma injection for the treatment of chronic non-healing ulcers.

Efficacy of autologous platelet-rich plasma on graft uptake in myringoplasty: a single-blinded randomized control trial

Background and aimChronic otitis media is defined as a chronic inflammation of the middle ear cleft producing irreversible pathological changes. The myringoplasty aims at the reconstruction of the tympanic membrane using a graft material. Autologous platelet-rich plasma can be used along with the graft to have a successful outcome. The aim of the study was to assess the efficacy of autologous platelet-rich plasma on graft uptake in myringoplasty.MethodsThis was a randomized controlled trial with a sample size of 76 patients. All patients were above 18 and below 55 years of age diagnosed with chronic suppurative otitis media and were planned for myringoplasty. The participants were randomly allotted to two groups by block randomization (block of 4). Intra-operatively, group I (n=38) received platelet-rich plasma–soaked gel foam and group II (n=38) was taken as the control group who received saline-soaked gel foam and examined by a blinded examiner at the end of 1st and 3rd months.ResultsThe mean air-bone gap reduction post-operatively in the platelet-rich plasma group was 8.68 ± 4.8 (P value 0.034) and 6.05 ± 4.05 in the control group. The improvement in pure-tone average in the platelet-rich plasma group (P = 0.009) is more than that in the control group. The graft uptake was higher among the platelet-rich plasma group than the control group both at 1st and 3rd months (P value 0.049) which were statistically significant.ConclusionThe present study concludes that the usage of platelet-rich plasma in the conventional myringoplasty technique has improved the success rate of graft uptake and reduced the graft migration.Trial registrationClinical Trials Registry-India (ICMR-NIMS) CTRI/2020/04/024416. Date of registration: 01/04/2020. Date of enrolment of the first participant to the trial: 06/04/2020. URL of the trial registry: http://www.ctri.nic.in.HighlightsUsage of autologous platelet-rich plasma (PRP) in conventional myringoplasty in underlay technique.Assessment of graft uptake, percentage of perforation closure, and the audiological outcome.Significant mean reduction of ABG in the PRP group.Significant improvement in PTA average in the PRP group.Graft uptake and percentage of perforation closure were higher in the PRP group and the control group.PRP is also beneficial in revision cases.

A Study of Platelet-Rich Plasma in the Management of Chronic Nonhealing Ulcers

Background: Chronic nonhealing ulcers run protracted course and require prolonged rest and complete avoidance of pressure, antibiotics, and antiseptic dressing, which at times may not yield satisfactory results. Local application of certain growth factors is known to promote healing in these cases. Objectives: To study the efficacy of autologous platelet-rich plasma in the management of chronic nonhealing ulcers. Materials and Methods: Z-statistics and Chi-square tests were used in the statistical analysis of this study. The study consisted of 30 patients of chronic nonhealing ulcers who presented to the dermatology department. Patients aged between 18 and 65 years of both sexes presenting with noninfective ulcer of duration of more than 6 weeks, treated or untreated and who have normal complete blood picture, were recruited. Diabetic patients with uncontrolled sugar levels were excluded. Ulcer examination was carried out as per clock-face method. Examination of peripheral pulses, nerves, and sensations was carried out. Routine hematological and biochemical investigations were done. Platelet-rich plasma was prepared from patient's blood, and 1.5–2 ml was injected at the healing margins using insulin syringe (26 G) after cleaning. Procedure was repeated once weekly for 6 weeks, and the ulcer healing was assessed. Results: Of the 30 cases, 21 (70%) were male and 9 (30%) were female, with a male-to-female ratio of 2.3:1. A maximum number of cases were in the fifth decade (33.3%). Trophic ulcers (TUs) due to leprosy contributed to 30 (88.23%), venous ulcers (VUs) 2 (5.88%), and diabetic ulcers 2 (5.88%). Improvement in area of TUs due to leprosy was 92.5%, in VUs 88.45%, and in diabetic ulcer 98.02% at the end of 6 weeks of platelet-rich plasma therapy. Conclusion: Platelet-rich plasma is an easily obtainable blood derivative and is a safe and potentially reasonable adjunct in the treatment of chronic nonhealing ulcers with advantage of no concern of immune reactions or cross-reactions or toxicity. It not only promotes healing but also prevents amputation necessitated by complications due to chronic ulcers.

Can platelet-rich plasma injections provide better pain relief and functional outcomes in persons with common shoulder diseases: a meta-analysis of randomized controlled trials.

BackgroundTo evaluate the efficacy of autologous platelet-rich plasma (PRP) injections in the treatment of common shoulder diseases.MethodsThe PubMed, Medline, and Central databases and trial registries were searched from their inception to October 2020 for randomized controlled trials of autologous PRP injections for shoulder diseases versus placebo or any control intervention. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed in the selection, analysis, and reporting of findings. The primary outcome was pain intensity (visual analog scale), and secondary outcomes were changes in function and quality of life (QoL).ResultsA total of 17 randomized controlled trials of PRP versus control were analyzed. From 8–12 weeks to ≥1 year, PRP injections were associated with better pain relief and functional outcomes than control interventions. PRP injections were also associated with greater QoL, with an effect size of 2.61 (95% confidence interval, 2.01–14.17) at medium-term follow-up. Compared with placebo and corticosteroid injections, PRP injections provided better pain relief and functional improvement. In subgroup analyses, trials in which PRP was prepared by the double centrifugation technique, the platelet concentration in the PRP was enriched ≥5 times, leucocyte-rich PRP was used, or an activating agent was used before application reported the most effective pain relief at 6–7 months.ConclusionsPRP injections could provide better pain relief and functional outcomes than other treatments for persons presenting with common shoulder diseases. PRP injections have a greater capacity to improve shoulder-related QoL than other interventions.

Platelet-rich Plasma and Its Application in Clinical Trial

Platelet-rich Plasma and Its Application in Clinical Trial

Comparative study of the therapeutic efficacy of autologous platelet-rich plasma and honey in healing skin wounds in sheep.

Background and Aim:This investigation is the continuation of a published preliminary study examining the therapeutic efficacy of platelet-rich plasma (PRP) as a topical treatment for skin wounds in sheep. The study aimed to compare the healing effects of autologous PRP with that of natural honey.Materials and Methods:This study involved nine clinically healthy male sheep. After sterile skin preparation, full-thickness longitudinal incision wounds were created on the backs of each animal. The animals were randomly divided into three groups of three sheep each. In Group I, the wounds were treated with PRP; in Group II, the wounds were treated with honey; and in Group III, the wounds were treated with saline solution. The different treatments were administered topically every 3 days. Healing was assessed by a semi-quantitative histopathological study from biopsies taken on the 3rd, 7th, 14th, 21st, and 28th days of healing. The data obtained were compared using the non-parametric Mann–Whitney U-test, and p<0.05 and 0.01 were used to determine the level of significance of the recorded differences.Results:Semi-quantitative histopathological evaluation showed significant differences in the progression of wound healing between the three study groups. Recorded data showed that PRP may reduce inflammation during the first 3 days after the incision. Moreover, the synthesis and organization of collagen fibers were significantly improved in the group treated with PRP compared with those in the group treated with honey.Conclusion:PRP offers a promising therapeutic option for healing skin wounds in sheep compared with honey.

Efficacy of autologous platelet-rich plasma in treating patients with burn wounds: A protocol for systematic review and meta-analysis.

Background:Burns are still regarded among severe health problems related to high morbidity and mortality rates globally. In essence, health problems associated with burns can cause significant economic burden to society. Regardless of treatment available options, no best treatment was considered adequate for treating severe burns. In particular, only a few studies have focused on the effect of autologous platelet-rich plasma to treat burn wounds. The present study aim to systematically review existing literature to examine the effectiveness and safety of autologous platelet-rich plasma (PRP) to treat burn wounds.Methods:For this study, we will conduct a systematic search using MEDLINE, EMBASE, the Cochrane Library, Web of Science, CINAHL, as well as Scopus to discover randomised controlled trials (RCTs) for the examination of effectiveness and safety of autologous PRP to treat burn wounds from their inception to March 2021 with no language restrictions. Additionally, we will search Google Scholar, ClinicalTrials.gov, as well as the reference lists of studies considered in the research to ascertain possibly eligible studies. We used two independent authors to evaluate studies for inclusion and conduct data extraction. We intend to assess study bias and quality utilizing the Cochrane Collaboration's Risk of Bias Tool 2.0. Also, we will pool study results using the fixed-effects model or random-effects model. Finally, any disagreements emanating from the process will be addressed through discussion or using a third author to mediate situations leading to disagreement.Results:The study aims at assessing the effectiveness and safety of autologous PRP for treating burn wounds.Conclusion:The study will provide specific substantiation to assess autologous PRP's effectiveness and safety in treating patients with burn wounds.Ethics and dissemination:The study does not require ethical approval since no published studies are used in it.OSF registration number:March 29, 2021.osf.io/74z5u. (https://osf.io/74z5u/)

Efficacy of Autologous Platelet-Rich Plasma Injections for Grade 3 Symptomatic Degenerative Meniscal Lesions: A 1-Year Follow-up Prospective Study.

Platelet-rich plasma (PRP) injections have been proposed as a biologic option to provide symptomatic relief and delay surgery in patients with degenerative joint disease of osteoarthritis (OA). The efficacy of autologous PRP on symptomatic degenerative meniscal lesions (DMLs) has never been investigated. We hypothesized that patients with symptomatic DMLs without OA undergoing autologous PRP injections experience a significant clinical improvement at 12 months. Prospective case series. Level 4. A total of 69 patients with symptomatic DMLs without radiographic evidence of knee OA (Kellgren-Lawrence radiographic grading scale 0-1) received 4 autologous PRP injections once a week. Patients were prospectively evaluated before the injection and then at 1, 3, 6, and 12 months. Evaluation was based on Lysholm knee scoring scale (primary outcome), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Tegner activity scale, and visual analogue scale scores. Patients treated with PRP injections demonstrated an improving knee function and symptoms over the duration of the study. A significant improvement from baseline to 12 months was observed in all the outcome measures, and no patients experienced failure or required surgery during the follow-up. Patients younger than 50 years reported lower subjective level of pain and higher Tegner activity scale at baseline and had significantly better Lysholm knee scoring scale (P = 0.03) and WOMAC (P = 0.03) scores at 6 months, as well as better range of motion at 3, 6, and 12 months (P < 0.001). Thirty-three (47.8%) patients were very satisfied, 26 (37.7%) satisfied, 8 (11.6%) partially satisfied, and 2 (2.9 %) not satisfied, with 62 (89.8%) patients willing to repeat the same treatment. No patient was lost to follow-up and no patient experienced adverse reaction, infection, failure, recurrence or underwent further surgery. PRP injections provide short-term benefits in symptomatic DMLs. Although promising results were evident at 12 months, this is a preliminary study and no definitive recommendation can be made based, for example, on longer follow-up. This research supports the use of autologous PRP injections for symptomatic DMLs.

Therapeutic Efficacy of Urethral Sphincter Injections of Platelet-Rich Plasma for the Treatment of Stress Urinary Incontinence due to Intrinsic Sphincter Deficiency: A Proof-of-Concept Clinical Trial.

PurposeThe aim of this study was to investigate the efficacy of autologous platelet-rich plasma (PRP) in the treatment of stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD) refractory to medical treatment.MethodsThirty-five patients with SUI due to urodynamically proven ISD were prospectively enrolled. Five milliliters of PRP (2.5–5 times the platelet concentration in peripheral blood) was injected into the external sphincter at 5 sites; all patients received 4 injections at monthly intervals. The primary end-point was the change in SUI severity as assessed by a visual analogue scale (VAS of SUI). The secondary-endpoints were the Global Response Assessment score and changes in urodynamic parameters from baseline to 3 months after treatment.ResultsThe mean age of patients was 68.7±12 years; the median duration of SUI was 4 years. Five patients had neurogenic SUI, while 30 had nonneurogenic SUI (21 with postprostatectomy incontinence, 6 with previous radical cystectomy, and 3 with other etiologies). Complete dryness was achieved in 7 patients (20.0%) while moderate improvement was observed in 14 (40.0%). The mean VAS of SUI score decreased significantly from 6.57±1.89 to 3.77±2.41 after treatment. The abdominal leak point pressure (ALPP) increased significantly from 98.3±55.8 to 157.3±79.3 cm H2O. There was no increase of ALPP in neurogenic SUI and less increase of ALPP in patients with failed treatment outcomes. No perioperative adverse events or severe complications occurred.ConclusionsUrethral PRP injection is safe and effective in increasing urethral resistance and improving SUI. PRP could be an alternative treatment modality for male and female patients with moderate SUI due to nonneurogenic causes.