The Use of Platelet-rich Plasma in Delayed Infected Surgical Wounds: A Randomized Controlled Trial

Background: Delayed infected surgical wounds pose significant clinical challenges, often leading to prolonged morbidity and increased healthcare costs.Platelet-rich plasma (PRP), rich in growth factors and antimicrobial components, has emerged as a potential therapy to enhance wound healing.This study evaluates PRP's efficacy in managing such wounds.Objective: To assess the efficacy of PRP compared to standard wound care in a randomized controlled trial (RCT) with a robust sample size and dropout analysis.Materials and methods: A single-center RCT was conducted from March to August 2023, enrolling 98 patients (50 PRP, 48 controls) with infected surgical wounds (>4 weeks nonhealing).Patients were randomized (1:1) to receive either weekly autologous PRP injections plus standard care (debridement, antibiotics, dressings) or standard care alone for 4 weeks.Primary outcomes were wound healing rate (Bates-Jensen wound assessment tool [BWAT] score reduction) and infection resolution.Secondary outcomes included bacterial load reduction and time to complete epithelialization.Intention-to-treat (ITT) analysis was used to handle dropouts.Results: After accounting for dropouts (8 PRP, 10 controls), the PRP group showed significantly faster healing (68% vs 42% BWAT score reduction, p < 0.01) and greater infection resolution (85% vs 55% bacterial load reduction, p < 0.05).Median healing time was 21 days (PRP) vs 35 days (control, p = 0.003).Conclusion: Platelet-rich plasma significantly improves healing and infection control in delayed infected surgical wounds, even after attrition adjustment.These findings support PRP's role as an effective adjunct therapy, warranting further multicenter studies to confirm generalizability.