Table 3 Clinical trial summary
Author, year | Design, no. subjects | Indication | Objective | PRP type used | Control | Types of bacteria targeted | Results | Oxford level bias notes |
|---|---|---|---|---|---|---|---|---|
Dorge, 2013 [5] | Randomized (N = 196) (underpowered and no a priori power and sample size estimate so no stopping criteria) | DSWI | To investigate whether topical application of autologous PRP reduced the incidence of DSWI in patients with high risk undergoing cardiac surgery with full sternotomy | PRP (N = 97) | Wound care (N = 99) | Not reported | * In PRP group 6 (6.2%) patients had DSWI versus 3 (3.0%) patients in control group | 2b |
Serraino, 2015 [32] | Retrospective (N = 1093) | DSWI | To evaluate whether PRP applied inside the sternotomy wound would reduce the effect of sternal wound infections, both superficial and deep | PRP | Median sternotomy but without PRP application | Not reported | * Occurrence of DSWI was significantly higher in control than PRP group (10/671, 1.5% versus 1/422, 0.2%, P = 0.043) | 2b |
* Superficial sternal wound infections (SSWIs) were significantly higher in control than PRP group (19/671, 2.8% versus 2/422, 0.5%, P = 0.006) | ||||||||
* PRP can significantly reduce occurrence of DSWI and SSWI in cardiac surgery | ||||||||
Hamman, 2014 [3] | Retrospective (N = 1866) | Severe DSWI | To evaluate impact of vancomycin, calcium-thrombin, and PRP in practice on incidence of severe DSWIs in a single surgeon’s patient population | PRP (N = 548) | Historical control (N = 1318) received routine antibiotic prophylaxis | Not reported | * Overall, 11 patients (0.59%) developed severe DSWIs (categories 5 and 6) in control group | 2c |
* No severe incidence of DSWI in the intervention group (548 patients) | ||||||||
Patel, 2016 [4] | Prospective (N = 2000) | DSWI | To analyze addition of PRP using a rapid point of care bedside system to standard wound care in all patients undergoing sternotomy for cardiac surgical procedures | Autologous PRP (N = 1000) | Standard of care sternal closure including preoperative antibiotics (N = 1000) | Not reported | * PRP reduced incidence of DSWI from 2.0 to 0.6%, SWI from 8.0 to 2.0%, and readmission rate from 4.0 to 0.8% | 2b |
* PRP reduced costs associated with development of deep and superficial wound complications from $1,256,960 to $593,791 | ||||||||
Wozniak, 2016 [51] | Prospective (N = 34) | Leg ulcers | To perform qualitative analysis of microbial flora in venous leg ulcers treated with PRP | PRP | Pretreatment microbial flora | * P. aeruginosa | * PRP given as intradermal injection and after PRP therapy, a significant healing improvement was shown in 21 subjects (61.8%), as assessed by decrease in wound size | 4; underpowered |
* S. aureus | * There was no improvement in 13 subjects (38.2%) | |||||||
* E. faecalis | * S. aureus and P. aeruginosa were most commonly identified bacteria | |||||||
* B. fragilis | * 83 different microbial flora were identified from wound | |||||||
* 83 microbial flora identified from wound | * After PRP therapy, 110 bacterial isolates were obtained from samples collected after a single, local application of PRP | |||||||
* The mean number of bacterial species isolated per subject was 2.44 ± 0.22 before and 3.24 ± 0.29 after PRP | ||||||||
Englert, 2005 [53] | Prospective, randomized (N = 34) | Cardiovascular surgery | To examine effects of autologous platelet gel on postoperative sternal wound healing by subjective reports of chest and leg pain, amount of measurable bruising, and platelet indices pre- and postoperatively | PRP gel | Standard of care |  | * There was a significant decrease in chest and leg pain with PRP treatment | 4 |
* PRP decreased bruising but was not statistically significant compared to control | ||||||||
Tran, 2014 [54] | Prospective, single arm (N = 6) | Diabetic foot ulcer | To examine effects of autologous platelet gel on postoperative sternal wound healing by subjective reports of chest and leg pain, amount of measurable bruising, and platelet indices pre- and postoperatively | PRP gel | Not reported |  | * PRP and PPP application caused increased wound healing (100%) by week 7 | 4 |
Vang, 2017 [55] | Prospective, randomized (N = 38) | Surgical wound healing | To examine whether autologous platelet gel to sternum and saphenous vein harvest site was beneficial to patients undergoing coronary artery revascularization in terms of pain, blood loss, discoloration, and surgical site infection | PRP gel | Standard wound care without PRP |  | * 8 patients discontinued the study due to complication with coronary artery bypass graft surgery | 4 |
* There was no incidence of deep or superficial sternal infections | ||||||||
* One patient from treatment and control group experienced a leg infection at the saphenous vein harvesting site after hospital discharge | ||||||||
* Patients reported less postoperative pain in PRP group versus control group |