A Comparative Study of Platelet-Rich Plasma and Normal Saline Dressings in the Treatment of Chronic Wounds: Platelet-Rich Plasma and Normal Saline Dressings in Chronic Wounds Treatment

Shahid Hussain; Asiya Shabbir

doi:10.54393/pjhs.v6i10.2736

Authors

Shahid Hussain Department of Surgery, Bahawal Victoria Hospital, Bahawalpur, Pakistan
Asiya Shabbir Department of Surgery, Bahawal Victoria Hospital, Bahawalpur, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i10.2736

Keywords:

Chronic Wounds, Platelet-Rich Plasma, PRP Dressing, Wound Healing, Diabetic Ulcers, Pressure Ulcers

Abstract

Chronic wounds pose a major challenge in clinical practice, often requiring advanced interventions. Platelet-rich plasma (PRP) dressings, by releasing growth factors, have emerged as a promising alternative to conventional approaches. Objectives: To compare the efficacy of PRP versus normal saline (NS) dressings in promoting wound healing. Methods: This randomized controlled trial was conducted at the Department of Surgery, Bahawal Victoria Hospital, Bahawalpur, from April to October 2024. A total of 156 patients with chronic wounds were randomized into PRP (n = 78) or NS (n = 78) groups. Baseline characteristics were recorded, and patients were followed for six weeks. Healing outcomes were analyzed using Chi-square and t-tests, with significance set at p≤0.05. Results: The PRP group achieved significantly higher healing (91.0%) compared to the NS group (66.7%) (p=0.000). Subgroup analysis revealed greater efficacy of PRP in older patients, female, immobile individuals, and those with long-standing wounds. PRP also showed superior results in diabetic (p=0.007) and pressure ulcers (p=0.004), though not in venous ulcers (p=0.477). Conclusions: PRP enhances chronic wound healing compared to saline dressings, with particular benefits in high-risk patient groups. It is a safe and effective therapeutic option.

References

Khan MP, Ali H, Kumar S. Efficacy of Platelet Rich Plasma for Acceleration of Healing in Chronic Wounds. The Journal of the Pakistan Medical Association. 2024; 74(9): 1634-1637. doi: 10.47391/JPMA.10719. DOI: https://doi.org/10.47391/JPMA.10719

Li S, Xing F, Yan T, Zhang S, Chen F. The Efficiency and Safety of Platelet-Rich Plasma Dressing in the Treatment of Chronic Wounds: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Personalized Medicine. 2023 Feb; 13(3): 430. doi: 10.3390/jpm13030430. DOI: https://doi.org/10.3390/jpm13030430

Xia Y, Zhao J, Xie J, Lv Y, Cao DS. The Efficacy of Platelet-Rich Plasma Dressing for Chronic Nonhealing Ulcers: A Meta-Analysis of 15 Randomized Controlled Trials. Plastic and Reconstructive Surgery. 2019 Dec; 144(6): 1463-74. doi: 10.1097/PRS.0000000000006281. DOI: https://doi.org/10.1097/PRS.0000000000006281

Bishnoi A, Gupta J, Verma N, Bishnoi M, Chauhan P, Chaudhary M. Comparative efficacy of autologous platelet-rich plasma and conventional dressing in managing chronic ulcers. International Surgery Journal. 2024; 11(10): 1641–1644. doi: 10.18203/2349-2902.isj20242764. DOI: https://doi.org/10.18203/2349-2902.isj20242764

Xu P, Wu Y, Zhou L, Yang Z, Zhang X, Hu X et al. Platelet-Rich Plasma Accelerates Skin Wound Healing by Promoting Re-Epithelialization. Burns and Trauma. 2020; 8: tkaa028. doi: 10.1093/burnst/tkaa028. DOI: https://doi.org/10.1093/burnst/tkaa028

Ali MF, Palaniappan NK, Chellappa PM. Effectiveness of Autologous Platelet-Rich Plasma Dressing in Healing Chronic Diabetic Foot Ulcers in Comparison with Saline Dressing. A Randomized Control Study. Journal of Current Research in Scientific Medicine. 2023 Jan; 9(1): 61-6. doi: doi: 10.4103/jcrsm.jcrsm_69_22. DOI: https://doi.org/10.4103/jcrsm.jcrsm_69_22

Pareek M, Kumar A, Jakhar D. Clinical Study of Topical Application of Platelet-Rich Plasma in Management of Chronic Wounds. Asian Journal of Pharmaceutical and Clinical Research. 2023; 16(12): 138-144. doi: 10.22159/ajpcr.2023.v16i12.48338. DOI: https://doi.org/10.22159/ajpcr.2023.v16i12.48338

Jose AM and Mahakalkar CC. Platelet-Rich Plasma as A Treatment Modality for Wound Healing: An Open Randomized Controlled Trial. Journal of the Association of Physicians of India. 2024 Aug; 72(8): e26-e30. doi: 10.59556/japi.72.0428. DOI: https://doi.org/10.59556/japi.72.0428

Zafar S, Reza S, Mazhar S, Yasmine T, Ajmal S. Plasma Rich Platelet Efficacy in Healing of Chronic Wounds. The Professional Medical Journal. 2022 May; 29(06): 855-8. doi: 10.29309/TPMJ/2022.29.06.6291. DOI: https://doi.org/10.29309/TPMJ/2022.29.06.6291

Somani A and Rai R. Comparison of Efficacy of Autologous Platelet-Rich Fibrin Versus Saline Dressing in Chronic Venous Leg Ulcers: A Randomized Controlled Trial. Journal of Cutaneous and Aesthetic Surgery. 2017 Jan; 10(1): 8-12. doi: 10.4103/JCAS.JCAS_137_16. DOI: https://doi.org/10.4103/JCAS.JCAS_137_16

Dimova A, Boroš M, Dimov S, Konjevod J, Svetec M. Platelet-Rich Plasma Treatment for Chronic Wounds: A Case Report and Literature Review. World Journal of Clinical Cases. 2024 Nov; 12(33): 6635. doi: 10.12998/wjcc.v12.i33.6635. DOI: https://doi.org/10.12998/wjcc.v12.i33.6635

Hoque A. What Kind of Dressing Is Important to Ensure Wound Healing with the Application of Platelet-Rich Plasma in Chronic Ulcers? Cureus. 2024 Mar; 16(3). doi: 10.7759/cureus.56758. DOI: https://doi.org/10.7759/cureus.56758

Orban YA, Soliman MA, Hegab YH, Alkilany MM. Autologous Platelet-Rich Plasma Vs Conventional Dressing in the Management of Chronic Diabetic Foot Ulcers. Wounds: A Compendium of Clinical Research and Practice. 2022 Feb; 33(2): 36-42. doi: 10.25270/wnds/2022.3642. DOI: https://doi.org/10.25270/wnds/2022.3642

Lwanga SK and Lemeshow S. Sample Size Determination in Health Studies. Geneva: World Health Organization. 1991 Sep: 1.

Stotts NA, Rodeheaver GT, Thomas DR, Frantz RA, Bartolucci AA, Sussman C et al. An Instrument to Measure Healing in Pressure Ulcers: Development and Validation of the Pressure Ulcer Scale for Healing (PUSH). The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2001 Dec; 56(12): M795-9. doi: 10.1093/gerona/56.12.M795. DOI: https://doi.org/10.1093/gerona/56.12.M795

Fibrini D, Lister IN, Rosadi I. Autologous Platelet-Rich Plasma in the Management of Diabetic Foot Ulcer: A Systematic Review of Randomized Controlled Trials. Journal of Skin and Stem Cell. 2022 Jan; 9(02): 1-7. doi: 10.5812/jssc-126907. DOI: https://doi.org/10.5812/jssc-126907

El-Mabood A, El-Sayed A, Ali HE. Platelet-Rich Plasma Versus Conventional Dressing: Does This Really Affect Diabetic Foot Wound-Healing Outcomes? The Egyptian Journal of Surgery. 2018 Jan; 37(1). doi: 10.4103/ejs.ejs_83_17. DOI: https://doi.org/10.4103/ejs.ejs_83_17

Syafira F, Iman MB, Sriwulandari R. Platelet-Rich Plasma (PRP) as Therapy for Diabetic Foot Ulcer (DFU): A Systematic Review and Meta-Analysis of the Latest Randomized Controlled Trials. Diabetes Epidemiology and Management. 2024 Jan; 13: 100178. doi: 10.1016/j.deman.2023.100178. DOI: https://doi.org/10.1016/j.deman.2023.100178

Elsaid A, El‐Said M, Emile S, Youssef M, Khafagy W, Elshobaky A. Randomized Controlled Trial on Autologous Platelet‐Rich Plasma Versus Saline Dressing in Treatment of Non‐Healing Diabetic Foot Ulcers. World Journal of Surgery. 2020 Apr; 44(4): 1294-301. doi: 10.1007/s00268-019-05316-0. DOI: https://doi.org/10.1007/s00268-019-05316-0

Peng Y, Wang J, Liu X, Zhou Y, Jia S, Xu J et al. Efficacy of Platelet-Rich Plasma in the Treatment of Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis. Annals of Vascular Surgery. 2024 Jan; 98: 365-73. doi: 10.1016/j.avsg.2023.05.045. DOI: https://doi.org/10.1016/j.avsg.2023.05.045

Suthar M, Gupta S, Bukhari S, Ponemone V. Treatment of Chronic Non-Healing Ulcers Using Autologous Platelet Rich Plasma: A Case Series. Journal of Biomedical Science. 2017 Feb; 24(1): 16. doi: 10.1186/s12929-017-0324-1. DOI: https://doi.org/10.1186/s12929-017-0324-1