Therapeutic Effects Of Autogenous Platelet-rich Plasma(PRP)and Traditional Methods For Diabetic Foot Ulcer:a Meta-analysis

Objective:Diabetic Foot Ulcer(DFU)is a composite tissue disease in foots or legs of diabetes patients,which is caused by diabetic peripheral neuropathy and peripheral vasculopathy.DFU is one of the severe complications threatening the diabetic patients.The wound of DFU is difficult to heal,often result in disastrous consequences and even amputation.Therefore,it is very important and a priority to treat the DFU timely and properly.For a long time,people have been exploring the treatment methods for DFU.There are many reports indicated that autogenous platelet-rich plasma(PRP)has showed an excellent performance in the treatment of DFU,but no consensus has yet been reached.In this study,we systematically evaluated the therapeutic effects of PRP and traditional methods in the treatment of DFU.The results from our study will provide the further evidence for future scientific research and clinical applications.Methods:The clinical data of patients with DFU were collected from the databases of Pubmed,the Cochrane Library,Embase,China hownet,weipu database,and Wanfang database by using keywords in combination with free word mainly recall strategy,retrieval of platelet rich plasma(PRP)treatment of DFU control study,the manual literature searching was also applied.The final inclusive literatures were determined according to the inclusive and exclusive criteria,and the basic information and diagnostic test data of the included studies were extracted.The efficacy of PRP therapy and traditional therapy for DFU was meta-analyzed and the statistical analyses were performed by using the statistical software STATA 14.0,meta-disc 1.4 and Revman 5.3.Results:Through careful selection,there were 12 papers which published in recent10 years were eventually included with a total of 697 patients,346 patients in PRP group and 351 patients in traditional method group,respectively.There was no statistical difference in age and gender between the two groups.The overall curative ratio was higher in PRP group than that in traditional method group significantly,they were(279/346)vs(195/351),respectively(OR=3.77,95%ci =2.62-5.41,Z=7.18,P<0.00001).In the treatment cycle,PRP group was significantly shorter than control group,respectively(MD=-16.51,CI=-27.62—-5.41,Z=2.91,P=0.004).In terms of the wound area after treatment,the PRP group showed a smaller area numerically,112 patients in the PRP group,while 108 patients in the control group(MD=-2.40,CI=-6.94-2.13,Z=1.04,P=0.30).However,there was no statistical difference in the data forest diagram analysis.Conclusion:According to the comprehensive analysis in this paper,compared to the traditional treatment of DFU,the PRP therapy have showed the significant higher curative rate,shorter wound healing time,and reduced the treatment cycle.This indicated that the PRP method has an obvious advantage for the treatment of DFU.It is worth popularizing and applying widely in clinic.However,PRP,as a new product,is still in the exploration stage in production and application,and there are still many defects,such as disunity in the preparation process,direction of data recording,measurement method and other factors.The data recorded in this paper are not detailed enough,which may lead to the inability of comprehensive meta-analysis.All in all,there are still many aspects of PRP method remain to be further explored and improved.We expect more large case-control studies in the future.