The evidence behind the use of platelet-rich plasma (PRP) in scar management: a literature review

• Published in: Scars, Burns & Healing Vol. 4; p. 2059513118808773
• Main Authors: Alser, Osaid H, Goutos, Ioannis
• Format: Book Review Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2018; Sage Publications Ltd; SAGE Publishing
• Subjects: Lasers; Literature reviews; Review; Wound healing; keloid; traumatic; scar; management; platelet; Atrophic; concentrate; platelet-rich plasma; PRP
• ISSN: 2059-5131; 2059-5131
• DOI: 10.1177/2059513118808773

Introduction: Autologous platelet-based concentrates represent increasingly popular adjuncts to a variety of medical, surgical and aesthetic interventions. Their beneficial potential rests on the ability to deliver a high concentration of growth factors to the target tissues. There are currently no reports in the literature appraising the evidence behind the use of platelet-rich plasma (PRP) in scar management. Methods: A detailed English literature review was conducted using PubMed Medline, Embase and Web of Science; the manuscripts were appraised and classified according to the Joanna Briggs Institute Levels of evidence. The results are presented in descending order of evidence separately for atrophic, keloid, surgical and traumatic scars. Discussion: On the basis of level 1 evidence currently available, it appears that PRP can improve the quality of atrophic acne scars treated with ablative fractional CO2 laser and decrease the duration of laser-related side effects including oedema and erythema. Regarding surgical scars, the current data suggest that PRP may improve wound healing and early scar quality; furthermore, incorporation of PRP in fat-grafting procedures undertaken in conjunction with non-ablative, fractional laser can contribute to better wound healing as well as a significant improvement in texture, colour and contour in traumatic scar resurfacing. There are no high level studies at present to support the incorporation of autologous platelet-based concentrates in the management of keloid scars. Conclusion: PRP is a promising adjunct in scar management practice. Further research with long-term follow-up is warranted to delineate the value of this modality in different subtypes of scars. Lay summary Platelet-rich plasma (PRP) is an increasingly popular product used in a variety of medical, surgical and aesthetic interventions; it is derived by spinning down a patient’s own blood and applying it back to an area of the body undergoing an intervention. We undertook this study to find out whether the use of PRP can have a beneficial effect on scars. We conclude that at present there is some evidence that it may improve the quality of depressed acne scars and ameliorate the duration of side effects associated with fractional laser treatment. Furthermore, PRP can improve healing parameters and early scar quality following a Caeserean section as well as enhance outcomes if used in combination with fat grafting and fractional laser for the revision of traumatic scars. The evidence behind the role of PRP for the management of keloid scars is low at present. Most studies do not assess long-term results, so further research is needed before PRP is widely adopted in scar management protocols.