Platelet Rich Plasma in chronic leg ulcer: systematic review and metanalysis

The wound topical treatment aims to stimulate an effective, rapid and safe wound healing. The platelet rich plasma (PRP) – a concentrated of platelets obtained from centrifugation or single aphaeresis – has been used as a treatment of wounds because it contains platelet derived growth factor. Being a new therapy, the aim of this study was to search the evidences about the effectiveness of PRP on the healing process of chronic leg ulcers.  A systematic review was conducted as recommended by Cochrane Library. The studies were screened until 2006 using some indexed and no indexed descriptors like: platelet rich plasma, platelet derived growth factor, platelet gel, platelet releasate, platelet lysate, CT-102 activated supernatant, wound healing, chronic wound, foot ulcer, diabetic foot, and varicose ulcer, in different combinations according to data base (Cochrane, PubMed, Lilacs, Embase, e Cinahal). From 56 studies, 18 were clinical trials, specially found in PubMed (17/94.5%), originated in USA (12/ 66.6%) and published in English. All of them were analyzed about their scientific quality through Evaluation of Recommendation and Evidence Level Scale (proposed by Nobre and Bernardo 2006), Variables Evaluation and Control Scale (based on the variables studied on identified studies) and Jadad Scale (randomization, blindness and losses). Seven (39%) were randomized clinical trials, classified as strong recommendation (A level) with high evidence level. As they obtained three or more points, they were submitted to metanalysis. The metanalysis of these 7 RCT showed the PRP promoted wound healing (CI95% 1.84-7.41), mainly in diabetic ulcer (CI95% 2.7-41-4). In conclusion, this study provides scientific evidences PRP promotes healing of chronic leg wounds mainly of diabetic ulcers.