ABSTRACT
BACKGROUND: Platelet-rich plasma has been used in the treatment of wounds in orthopedics, burn and plastic surgery, and has achieved good results. But its therapeutic effect in diabetic foot ulcers is still controversial. OBJECTIVE: To systematically evaluate the efficacy and safety of platelet-rich plasma in diabetic foot ulcer. METHODS: PubMed, EMbase, The Cochrane Library, CBM, CNKI, and VIP databases were searched for a randomized controlled trial of platelet-rich plasma for treating diabetic foot ulcers published before September 2018. Meta-analysis was performed using RevMan 5.3 software after two investigators independently screened the literature, extracted the data, and assessed the risk of bias in the included studies. RESULTS AND CONCLUSION: (1) Sixteen randomized controlled trials were included, including 925 patients. The trial group was treated with platelet-rich plasma alone or platelet-rich plasma combined with conventional therapy (debridement, vacuum sealing drainage, or dressing coverage) . The control group received routine treatment, blank control or placebo treatment. (2) Meta-analysis showed that the healing rate in the trial group was higher than that in the control group [OR=3.05, 95％CI (2.25, 4.13) , P < 0.000 01]; effective rate was higher than that in the control group [OR=3.84, 95％CI (2.44, 6.06) , P < 0.000 01]; the ulcer healing time was shorter than that in the control group [MD=-11.39, 95％CI (-13.45, -9.34) , P < 0.000 01]; the cost of treatment was lower than that in the control group [MD=-5 927.76, 95％CI (-10 413.04, -1 442.49) , P=0.010]; and the hospitalization time was less than that in the control group [MD=-14.77, 95％CI (-18.82, -10.73) , P < 0.000 01]. (3) Four studies reported adverse reactions, but adverse reactions were not associated with platelet-rich plasma. (4) These results suggest that platelet-rich plasma has a good clinical effect in promoting the healing of diabetic foot ulcers, and no adverse reactions occur. Due to limitations in the quantity and quality of the studies, the above conclusions are yet to be verified by more high-quality studies.