Abstract:
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 1st , 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 I2 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.
摘要:
尽管在各种类型的疤痕的管理中应用富血小板血浆(PRP)的趋势不断上升,没有令人信服的证据支持它的使用。这促使我们回顾研究PRP有效性和安全性的随机临床试验,单独或与其他方法结合使用,用于管理萎缩性或肥厚性/瘢痕疙瘩疤痕。WebofScience,Scopus,谷歌学者,和Cochrane图书馆数据库被系统地搜索到9月1日,2020年。13项临床试验被纳入荟萃分析,并对10个以上的结果进行了审查。随机效应荟萃分析方法用于评估每种治疗类型的每种结果的效应大小,和I2用于计算研究之间的统计异质性。接受PRP治疗的患者总体反应率为23%,与激光或微针刺的结果相当(22%和23%,分别)单独使用时,中度改善是PRP最常见的反应程度(36%),而,当添加到激光或微针刺时,大多数患者经历了显著的(33%,43%,分别)或优秀(32%和23%,分别)结果。关于肥厚性/瘢痕疙瘩疤痕,唯一符合规定标准的研究报告称,在病灶内皮质类固醇中加入PRP后,改善更好,不良反应更少.富含血小板的血浆似乎是各种类型的萎缩性瘢痕的安全有效的治疗方法。此外,当添加到烧蚀激光或微针刺时,它似乎大大增加了治疗的功效并减少了副作用。