Reviewing and Exploring the Prospects of Platelet-Rich Plasma (PRP) Therapy in the Context of Pediatric Surgical Wound Management

Main Article Content

Devina Subagio
Ahmad Fawzy

Abstract

Pediatric surgical wound care is a critical aspect of medical practice, necessitating innovative approaches to optimize healing and minimize complications. Platelet-rich plasma (PRP) therapy has emerged as a promising intervention for enhancing wound healing in pediatric patients. This review comprehensively evaluates the efficacy, underlying mechanisms, and challenges associated with platelet-rich plasma (PRP) therapy in the context of pediatric surgical wounds.


Platelet-rich plasma (PRP), a biologic concentrate enriched with growth factors and cytokines, plays a pivotal role in wound healing by promoting cell proliferation, differentiation, and tissue regeneration. This article explores the mechanisms of action of this therapy in detail, focusing on its immunomodulatory effects and interaction with growth factors, and highlighting the significance of factors influencing platelet-rich plasma (PRP) efficacy, This article also gives examples of platelet-rich plasma (PRP) therapy in various pediatric surgical procedures, summarizes outcomes from clinical studies and trials, and addresses safety concerns and potential adverse effects associated with platelet-rich plasma (PRP) therapy in pediatric surgical wound management.


In conclusion, this review underscores the potential of platelet-rich plasma (PRP) therapy as an adjunctive treatment in pediatric surgical wound care. By elucidating its mechanisms, clinical efficacy, and challenges, the review provides insights for clinicians and researchers to guide evidence-based practice. Recommendations for future research and the integration of platelet-rich plasma (PRP) therapy into clinical guidelines emphasize the importance of refining protocols, ensuring cost-effectiveness, and adhering to ethical standards in pediatric surgical wound care.

Article Details

How to Cite
Subagio, D., & Fawzy, A. (2023). Reviewing and Exploring the Prospects of Platelet-Rich Plasma (PRP) Therapy in the Context of Pediatric Surgical Wound Management. International Journal of Medical Science and Clinical Research Studies, 3(8), 1770–1781. https://doi.org/10.47191/ijmscrs/v3-i8-63
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Articles

References

I. King A, Stellar JJ, Blevins A, Shah KN. Dressings and products in pediatric wound care. Adv Wound Care. 2014; 3(4): 324–334.

II. Gonzalez AC, Costa TF, Andrade ZA, Medrado AR. Wound healing - A literature review. An Bras Dermatol. 2016; 91(5):614-620.

III. McCord SS, Levy ML. Practical guide to pediatric wound care. Semin Plast Surg. 20016; 20(3): 192-199.

IV. Andia I, Abate M. Platelet rich plasma: underlying biology and clinical correlates. Regen Med 2013; 8(5): 645-658.

V. Conde Montero E, Fernández Santos ME, Suárez Fernández R. Platelet-rich plasma: applications in dermatology. Actas Dermosifiliogr. 2015; 106(2): 104-111.

VI. Andia E, Rubio-Azpeitia J, Martin I, Abate M. Current concepts and translational uses of platelet rich plasma biotechnology; in Ekinci D (ed.): Biotechnology. InTech. 2015.

VII. Alves R, Grimald R. A review of platelet-rich plasma: History, biology, mechanism of action, and classification. Skin Appendage Disord. 2018; 4(1):18-24.

VIII. Lynch MD, Bashir S. Applications of platelet-rich plasma in dermatology: a critical appraisal of the literature. J Dermatolog Treat 2016; 27(3): 285-289.

IX. Pavlovic V, Ciric M, Jovanovic V, Stojanovic P. Platelet rich plasma: a short overview of certain bioactive components. Open Med (Wars). 2016; 11(1): 242-247.

X. 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 Trauma. 2020; 8:tkaa028.

XI. Lian Z, Yin X, Li H, Jia L, He X, Yan Y, et al. Synergistic effect of bone marrow-derived mesenchymal stem cells and platelet-rich plasma in streptozotocin-induced diabetic rats. Ann Dermatol. 2014; 26(1):1–10.

XII. Zhang W, Guo Y, Kuss M, Shi W, Aldrich AL, Untrauer J, et al. Platelet-rich plasma for the treatment of tissue infection: Preparation and clinical evaluation. Tissue Eng Part B Rev. 2019; 25(3):225-236.

XIII. Sharun K, Pawde AM. Variables affecting the potential efficacy of platelet-rich plasma in dermatology. J Am Acad Dermatol. 2021; 84(1): e47-e48.

XIV. Dhurat R, Sukesh M. Principles and methods of preparation of platelet-rich plasma: A review and author's perspective. J Cutan Aesthet Surg. 2014; 7(4):189-197.

XV. Kuffler DP. Variables affecting the potential efficacy of platelet-rich plasma (PRP) in providing chronic pain relief. J Pain Res. 2018; 12:109-116.

XVI. Collins T, Alexander D, Barkatali B. Platelet-rich plasma: a narrative review. 2021. EFORT Open Reviews, 6(4):225-235.

XVII. Verma R, Kandwal A, Negi G, Chandra H. Factors affecting the quantity and quality of platelet-rich plasma and platelet-derived growth factor-BB: an observational study. Journal of Bio-X Research. 2021; 4:67-70.

XVIII. Maisel-Campbell AL, Ismail A, Reynolds KA, et al. A systematic review of the safety and effectiveness of platelet-rich plasma (PRP) for skin aging. Arch Dermatol Res. 2020; 312:301-315.

XIX. Delong JM, Beitzel K, Mazzocca AD, et al. Update on platelet-rich plasma. Curr Orthop Pract. 2011; 22:514-523.

XX. Gamal AY, Abdel Ghaffar KA, Alghezwy OA. Crevicular fluid growth factors release profile following the use of platelet-rich fibrin and plasma rich growth factors in treating periodontal intrabony defects: a randomized clinical trial. J Periodontol. 2016; 87:654-662.

XXI. Mahmud SMK, Laizu J, Rashid A, Islam A, Mahmud SM. Platelet rich plasma (PRP) therapy in pediatric surgical wound care: My experience in a tertiary care hospital in Bangladesh. Sch J App Med Sci. 2023; 11(1):120-126.

XXII. Xia Y, Zhao J, Xie J, Lv Y, Cao DS. The Efficacy of platelet-rich plasma dressing for chronic non-healing ulcers: A meta-analysis of 15 randomized controlled trials. Plast Reconstr Surg. 2019; 144(6):1463-1474.

XXIII. McAleer JP, Sharma S, Kaplan EM, Persich G. Use of autologous platelet concentrate in a nonhealing lower extremity wound. Adv Skin Wound Care. 2006; 19(7):354-363.

XXIV. Rozman P, Bolta Z. Use of platelet growth factors in treating wounds and soft-tissue injuries. Acta Dermatovenerol Alp Pannonica Adriat. 2007; 16(4):156-165.

XXV. O'Connell SM, Impeduglia T, Hessler K, Wang XJ, Carroll RJ, Dardik H. Autologous platelet-rich fibrin matrix as cell therapy in the healing of chronic lower-extremity ulcers. Wound Repair Regen. 2008; 16(6):749-756.

XXVI. Margolis DJ, Bartus C, Hoffstad O, Malay S, Berlin JA. Effectiveness of recombinant human platelet-derived growth factor for the treatment of diabetic neuropathic foot ulcers. Wound Repair Regen. 2005; 13(6):531-536.

XXVII. Refahee SM, Aboulhassan MA, Abdel Aziz O, et al. Is platelet-rich plasma (PRP) effective in reducing the scar Width of primary cleft lip repair? A randomized controlled clinical study. Cleft Palate Craniofac J. 2020; 57(5):581-588.

XXVIII. Gupta C, Mehrotra D, Mohammad S, Khanna V, Singh GK, Singh G, et al. Alveolar bone graft with platelet rich plasma in cleft alveolus. J Oral Biol Craniofac Res. 2013; 3(1):3-8.

XXIX. Patel AN, Selzman CH, Kumpat GS, McKellar SH, Bull DA. Evaluation of autologous platelet rich plasma for cardiac surgery: outcome analysis of 2000 patients. J Cardiothorac Surg 11. 2016; 62.

XXX. Hiramatsu T, Okamura T, Imai Y, Kurosawa H, Aoki M, SHin'oka T, et al. Effects of autologous platelet concentrate reinfusion after open heart surgery in patients with congenital heart disease. Ann Thorac Surg. 2022; 73:1282-1285.

XXXI. Okamura T, Koh E, Yokoyama S. Effect of autologous platelet-rich plasma (PRP) in cardiac surgery. The Japanese Journal of Thoracic Surgery. 2001; 54(5): 397-400.

XXXII. Domenichelli V, Straziuso S, Sabatino M, Federici S. Vacuum assisted closure (VAC) and platelet-rich plasma (PRP): A successful combination in a challenging case of gastroschisis. Open Journal of Pediatrics. 2015; 5(3):274-278.

XXXIII. Joudi M, Alamdari DH, Rahimi HR. Successful treatment of congenital chyloperitoneum with platelet-rich fibrin glue. Iran J Pediatr. 2013; 23(3):357-359.

XXXIV. Jordan KC, Di Gennaro JL, von Saint André-von Arnim A, Stewart BT. Global trends in pediatric burn injuries and care capacity from the World Health Organization Global Burn Registry. Front Pediatr. 2022; 10:954995.

XXXV. Huang H, Sun X, Zhao Y. Platelet-rich plasma for the treatment of burn wounds: A meta-analysis of randomized controlled trials. Transfus Apher Sci. 2021; 60(1):102964.

XXXVI. Chen Z, Wu Y, Turxun N, Shen Y, Zhang X. Efficacy and safety of platelet-rich plasma in the treatment of severe burns: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2020; 99(45):e23001.

XXXVII. Kao YC, Lin DZ, Lee SL, Chen C, Wang HJ, Chiu WK. Assisted therapy with platelet-rich plasma for burn patients: A meta-analysis and systematic review. Burns. 2021; 47(5):1012-1023.

XXXVIII. Pradnyandari NKPD, Natasha RR. The role of Platelet-Rich Plasma (PRP) in burn wound healing: a literature-review. Intisari Sains Medis. 2022; 13(2):507-510.

XXXIX. Jain NK, Gulati M. Platelet-rich plasma: a healing virtuoso. Blood Res. 2016; 51(1):3-5.

XL. Elsayed AB, Moiemen NS, Eloteify MM, Mousa AK. Applied effectiveness of platelet rich plasma on partial thickness facial burn healing in comparison to conventional facial burn care. Aswan University Med Journal. 2022; 2(2); 25-33.

XLI. Gupta S, Goil P, Thakurani S. Autologous platelet rich plasma as a preparative for resurfacing burn wounds with split thickness skin grafts. World J Plast Surg. 2020; 9(1):29-32.

XLII. Al Ibran E, Rao MH, Khan M, Hasan F. Efficacy of platelet rich plasma application in comparison to conventional dressing therapy in partial thickness burn wound. Medical Forum Monthly. 2014; 25(1):27-30.

XLIII. Klosová H, Stětinský J, Bryjová I, Hledík S, Klein L. Objective evaluation of the effect of autologous platelet concentrate on post-operative scarring in deep burns. Burns. 2013; 39(6):1263-1276.

XLIV. Kao YC, Lin DZ, Lee SL, Chen C, Wang HJ, Chiu WK. Assisted therapy with platelet-rich plasma for burn patients: A meta-analysis and systematic review. Burns. 2021; 47(5):1012-1023.

XLV. Oyama T, Nishimoto S, Tsugawa T, Shimizu F. Efficacy of platelet-rich plasma in alveolar bone grafting. J Oral Maxillofac Surg. 2004; 62(5):555-558.

XLVI. Tawfik C, Tejeda CI, Haughton AM. Case series evaluating the efficacy and safety of platelet-rich plasma for androgenetic alopecia in pediatric patients. JAAD Case Rep. 2023; 37:8-12.

XLVII. Huang SH, Wu SH, Lee SS, et al. Platelet-rich plasma injection in burn scar areas alleviates neuropathic scar pain. Int J Med Sci. 2018; 15(3):238-247.

XLVIII. Medina-porqueres I, Moreno-pedrosa C, Mateo-rodrıguez J, Rosado-velazquez D. An early-exercise-mediated adverse reaction associated with platelet-rich plasma therapy. Turk J Physiother Rehabil. 2022; 33(1):85-89.

XLIX. Latalski M, Walczyk A, Fatyga M, et al. Allergic reaction to platelet-rich plasma (PRP): Case report. Medicine (Baltimore). 2019; 98(10):e14702.

L. Puricelli C, Boggio E, Gigliotti CL, et al. Platelets, protean cells with all-around functions and multifaceted pharmacological applications. Int J Mol Sci. 2023; 24(5):4565.

LI. Cecerska-Heryć E, Goszka M, Serwin N, Roszak M, Grygorcewicz B, Heryć R, Dołęgowska B. Applications of the regenerative capacity of platelets in modern medicine. Cytokine Growth Factor Rev. 2022; 64:84-94.

LII. Gentile P, Garcovich S. Systematic review-the potential implications of different platelet-rich plasma (PRP) concentrations in regenerative medicine for tissue repair. Int J Mol Sci. 2020; 21(16):5702.

LIII. Misiura M, Guszczyn T, Oscilowska I, Baszanowska W, Palka J, Miltyk W. Platelet-rich plasma promotes the proliferation of human keratinocytes via a progression of the cell cycle. A role of prolidase. Int J Mol Sci. 2021; 22(2):936.

LIV. Wu J, Piao Y, Liu Q, Yang X. Platelet-rich plasma-derived extracellular vesicles: A superior alternative in regenerative medicine? Cell Prolif. 2021 Dec;54(12):e13123.

LV. Yamakawa S, Hayashida K. Advances in surgical applications of growth factors for wound healing. Burns Trauma. 2019; 7:10.

LVI. Landén NX, Li D, Ståhle M. Transition from inflammation to proliferation: a critical step during wound healing. Cell Mol Life Sci. 2016; 73(20):3861-3885.

LVII. Diller RB, Tabor AJ. The role of the extracellular matrix (ECM) in wound healing: A Review. Biomimetics (Basel). 2022; 7(3):87.

LVIII. Park JW, Hwang SR, Yoon IS. Advanced growth factor delivery systems in wound management and skin regeneration. Molecules. 2017; 22(8):1259.

LIX. Kauhl W, Pototschnig H, Paasch U. Can platelet-rich plasma reduce the burden of inflammatory skin diseases such as psoriasis and atopic dermatitis? Cureus. 2021; 13(10):e18472.

LX. Huber SC, de Lima Montalvão SA, Sachetto Z, Santos Duarte Lana JF, Annichino-Bizzacchi JM. Characterization of autologous platelet rich plasma (PRP) and its biological effects in patients with Behçet's disease. Regen Ther. 2021; 18:339-346.

LXI. Durán G, Luzo AMC, Favaro WJ, Durán N. Nanostructured platelet-rich plasma: state of art in dental treatments. Braz Dent Sci. 2020; 23(2):1-10.

LXII. Cognasse F, Laradi S, Berthelot P, Bourlet T, Marotte H, Mismetti P, Garraud O, Hamzeh-Cognasse H. Platelet inflammatory response to stress. Front Immunol. 2019; 10:1478.

LXIII. Tejapira K, Yongpisarn T, Sakpuwadol N, Suchonwanit P. Platelet-rich plasma in alopecia areata and primary cicatricial alopecias: A systematic review. Front Med (Lausanne). 2022; 9:1058431.

LXIV. de Castro Roston JR, Reis IB, Luzo ÂCM, Roston MO, Durán N, Fávaro WJ. Evaluation of the tissue repair process and immunomodulatory action of platelet-rich plasma (PRP) in the treatment of abdominal stretch marks. Tissue Cell. 2023; 83:102132.

LXV. Cavallo C, Roffi A, Grigolo B, Mariani E, Pratelli L, Merli G, Kon E, Marcacci M, Filardo G. Platelet-Rich Plasma: The choice of activation method affects the release of bioactive molecules. Biomed Res Int. 2016; 2016:6591717.

LXVI. Marlovits S, Mousavi M, Gäbler C, Erdös J, Vécsei V. A new simplified technique for producing platelet-rich plasma: a short technical note. Eur Spine J. 2004; 13 Suppl 1(Suppl 1): S102-6.

LXVII. Sweeny J, Grossman BJ. Blood collection, storage and component preparation methods. In: Brecher M, editor. Technical Manual. 14th ed. Bethesda MD: American Association of Blood Banks (AABB); 2002. pp. 955–8.

LXVIII. Macey M, Azam U, McCarthy D, Webb L, Chapman ES, Okrongly D, et al. Evaluation of the anticoagulants EDTA and citrate, theophylline, adenosine, and dipyridamole (CTAD) for assessing platelet activation on the ADVIA 120 hematology system. Clin Chem. 2002; 48:891–9.

LXIX. Anitua E, Prado R, Sánchez M, Orive G. Platelet-rich-plasma: Preparation and formulation. Oper Tech Orthop. 2012; 22:25–32.

LXX. Woodell-May JE, Ridderman DN, Swift MJ, Higgins J. Producing accurate platelet counts for platelet rich plasma: Validation of a hematology analyzer and preparation techniques for counting. J Craniofac Surg. 2005; 16:749–59.

LXXI. Pandunugrahadi M, Irianto KA, Sindrawati O. The optimal timing of platelet-rich plasma (PRP) injection for nerve lesion recovery: A preliminary study. Int J Biomater. 2022; 2022:9601547.

LXXII. Elgarhy LH, El-Ashmawy AA, Bedeer AE, Al-Bahnasy AM. Evaluation of safety and efficacy of autologous topical platelet gel vs platelet rich plasma injection in the treatment of venous leg ulcers: A randomized case control study. Dermatol Ther. 2020; 33(6): e13897.

LXXIII. Conde-Montero E, Horcajada-Reales C, Clavo P, Delgado-Sillero I, Suárez-Fernández R. Neuropathic ulcers in leprosy treated with intralesional platelet-rich plasma. Int Wound J. 2016; 13:726–728.

LXXIV. Sebastian KMS, Lobato I, Hernandez I, et al. Efficacy and safety of autologous platelet rich plasma for the treatment of vascular ulcers in primary care: phase III study. BMC Fam Pract. 2014; 15:211.

LXXV. Suthar M, Gupta S, Bukhari S, Ponemone V. Treatment of chronic non-healing ulcers using autologous platelet rich plasma: a case series. J Biomed Sci. 2017; 4(1):16.

LXXVI. American Diabetes Association. Diagnosis and classification of diabetes mellitus [published correction appears in Diabetes Care. Diabetes Care. 2010; 33 Suppl 1(Suppl 1):S62-S69.

LXXVII. Shi GJ, Shi GR, Zhou JY, Zhang WJ, Gao CY, Jiang YP, et al. Involvement of growth factors in diabetes mellitus and its complications: A general review. Biomed Pharmacother. 2018; 101:510-527.

LXXVIII. Zhang M, Lin Q, Qi T, Wang T, Chen CC, Riggs AD, et al. Growth factors and medium hyperglycemia induce Sox9+ ductal cell differentiation into β cells in mice with reversal of diabetes. Proc Natl Acad Sci U S A. 2016 Jan; 113(3):650-5.

LXXIX. Lister INE, Wienaldi. Antidiabetic effects of the Platelet Rich Plasma (PRP): A Review. Int J Res Pharm Sci. 2022; 13(3):292-296.

LXXX. Zarin M, Karbalaei N, Keshtgar S, Nemati M. Platelet-rich plasma improves impaired glucose hemostasis, disrupted insulin secretion, and pancreatic oxidative stress in streptozotocin-induced diabetic rat. Growth Factors. 2019; 37(5-6):226-237.

LXXXI. El-Tahawy NF, Rifaai RA, Saber EA, Saied SR, Ibrahim RA. Effect of platelet rich plasma (PRP) injection on the endocrine pancreas of the experimentally induced diabetes in male albino rats: A histological and immunohistochemical study. J Diabetes Metab. 2017; 8(3).

LXXXII. Gualtierotti R, Solimeno LP, Peyvandi F. Hemophilic arthropathy: Current knowledge and future perspectives. J Thromb Haemost. 2021; 19(9):2112-2121.

LXXXIII. Davoodabadi H, Malek F, Habibpanah B, Ghoojani A. The efficacy of platelet-rich plasma in the treatment of hemophilic arthropathy. J Res Orthop Sci. 2020; 7(4):165-168.

LXXXIV. Suman A, Owen J. Update on the management of burns in paediatrics. BJA Educ. 2020; 20(3):103-110.

LXXXV. Anyanwu JA, Cindass R. Burn Debridement, Grafting, and Reconstruction. 2023 May 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–.

LXXXVI. 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. J Pers Med. 2023; 13(3):430.

LXXXVII. Muthu S, Krishnan A, Ramanathan KR. Standardization and validation of a conventional high yield platelet-rich plasma preparation protocol. Ann Med Surg (Lond). 2022; 82:104593.

LXXXVIII. Oliveira BGRB, Carvalho MR, Ribeiro APL. Cost and effectiveness of Platelet Rich Plasma in the healing of varicose ulcer: Meta-analysis. Rev Bras Enferm. 2020; 73(4):e20180981.

LXXXIX. Sarvajnamurthy S, Suryanarayan S, Budamakuntala L, Suresh DH. Autologous platelet rich plasma in chronic venous ulcers: study of 17 cases. J Cutan Aesthet Surg. 2013; 6(2):97-9.

XC. Dougherty EJ. An evidence-based model comparing the cost-effectiveness of platelet-rich plasma gel to alternative therapies for patients with nonhealing diabetic foot ulcers. Adv Skin Wound Care. 2008; 21(12):568-75.

XCI. Cobos R1, Aizpuru F, Parraza N, Anitua E, Orive G. Effectiveness and efficiency of platelet rich plasma in the treatment of diabetic ulcers. Curr Pharm Biotechnol. 2015; 16(7):630-4,

XCII. Landi S, Landa P, Russo S. Knee OA management: A cost effectiveness analysis of platelet-rich plasma versus hyaluronic acid for the intra-articular treatment of knee OA in France. Int J Clin Rheumatol. 2018; 13(5):307-318.

XCIII. Codorean IB, Cernat E, Popescu D, Sinescu RD, Perlea P. Legal and ethical aspects of Platelet-Rich Plasma. Rom J Leg Med. 2017; 25(4):405-408.

XCIV. White C, Brahs A, Dorton D, Witfill K. Platelet-Rich Plasma: A comprehensive review of emerging applications in medical and aesthetic dermatology. J Clin Aesthet Dermatol. 2021; 14(11):44-57.

XCV. Nazaroff J, Oyadomari S, Brown N, Wang D. Reporting in clinical studies on platelet-rich plasma therapy among all medical specialties: A systematic review of Level I and II studies. PLoS One. 2021; 16(4): e0250007.

XCVI. Verma R, Kumar S, Garg P, Verma YK. Platelet-rich plasma: a comparative and economical therapy for wound healing and tissue regeneration. Cell Tissue Bank. 2023; 24:285–306.

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