Meta-Analysis of Platelet-Rich Plasma for Venous Ulcers: Clinical Efficacy and Complications

Abstract

Background: Venous leg ulcers (VLUs) result from chronic venous insufficiency, resulting in prolonged healing, high recurrence rates, and substantial economic burden. Traditional treatments, including compression therapy and wound care management, often lead to slow and incomplete healing. Platelet-rich plasma (PRP) is a potential therapy to enhance wound healing, though its effectiveness remains debated. This systematic review and meta-analysis assess PRP's impact on wound healing in VLUs compared to conventional treatments.

Methods: A systematic search was conducted in PubMed and Web of Science databases, including thirteen studies with a total of 554 patients. Healing outcomes, including complete and partial ulcer healing rates, were analyzed using binary random-effects models. Heterogeneity across studies was assessed using tau², Q-tests, and I² statistics.

Results: PRP treatment increased total wound healing by 50% compared to conventional treatments. The meta-analytical odds ratio (OR) of complete ulcer healing in PRP-treated patients was 1.5 [95% CI 1.09-2.07] (I2 = 58%). Ulcer area reduction was higher in the PRP group (OR: 16.37 [95% CI 6.45-26.28], I² = 97%). Complete healing at the fourth week showed a meta-analytical OR 3.65 [1.08-12.32], with substantial heterogeneity (I² = 61%, p < 0.001). Meta-regression revealed a significant positive association between age and treatment effect, while diabetes mellitus was a significant negative predictor. PRP reduced ulcer recurrence (OR: 0.25 [95% CI 0.06-0.99], p <0.001) with low heterogeneity.

Conclusion: PRP is an effective therapy for VLUs, significantly enhancing wound healing. These findings support PRP's integration into clinical practice, especially for patients with slow-healing or chronic wounds.