Platelet-rich plasma to treat experimentally induced skin wounds in animals: a systematic review and meta-analysis

To determine whether the topical application of platelet rich plasma (PRP) promotes clinically evaluable healing process in experimentally induced skin wounds in animals, systematic review and meta-analysis were conducted. The following databases were used: Web of Science, Cochrane Library, PubMed, Research Gate, Cochrane Wounds Group, Veterinary Information Network. No date or language restrictions were applied. Randomized and not randomized controlled clinical trials (CCTs) that compared PRP with placebo or alternative treatments for experimentally-induced full-thickness skin wounds left to heal by secondary intention in animals were included. The size of wound area reduction compared with baseline was the primary outcome; secondary outcomes were healing time and rate of healing. Hedges’s g for continuous variables and odds ratio for binary data were calculated as effect sizes (ES). Eighteen eligible CCTs were included in qualitative and quantitative synthesis, with a total of 661 wounds. Eight studies were carried out on rodent/lagomorph and 10 on non-rodent/lagomorph mammals. PRP group showed a better healing performance than control group in each outcome. The ES was statistically significant considering the primary outcome and the overall aggregation of outcomes. The heterogeneity was mild or moderate. Five studies reported a high risk of selection bias. The publication bias was always mild or absent. The results support the efficacy of the PRP. The PRP can be considered an effective adjunctive therapy for stimulating the wound healing process in animals.