Keywords
PRP
Pediatric Neonatal Wound Healing
Regenerative Medicine
Pediatric Surgical Wound Care
How to Cite
Abstract
Introduction. Platelet-rich plasma (PRP) is a regenerative therapy that delivers concentrated platelets and growth factors to promote angiogenesis, modulate inflammation, and support tissue repair. While its use is well established in adults, evidence on PRP for neonatal and pediatric wound management remains scarce and heterogeneous. This scoping review aimed to map the existing literature on PRP for cutaneous wound healing in patients aged 0-18 years and to assess the presence of standardized preparation or application protocols.
Methods. The review followed Arksey and O’Malley’s methodological framework, enhanced by Levac et al., and was reported according to PRISMA-ScR guidelines. Searches were conducted in PubMed, Scopus, and Google Scholar (January 2014-April 2025), complemented by backward/forward reference screening and gray literature searches. Eligible studies included neonates, children, or adolescents receiving PRP for any cutaneous wound etiology. Data were extracted on study design, population characteristics, wound type, PRP preparation/application, and clinical outcomes.
Results. A total of 1,812 records were identified, with 8 sources meeting inclusion criteria: 4 clinical pediatric wound-care studies, 3 randomized surgical trials, and 1 congress-level protocol. Reported outcomes included rapid healing of neonatal and pediatric surgical dehiscence (mean ~12 days), complete resolution of a chronic neuropathic ulcer within 2 weeks, and >50% ulcer reduction in pediatric chronic graft-versus-host disease. Surgical trials showed reduced fistula formation, postoperative edema, and complications. One transient citrate-related reaction was the only adverse event recorded. Across studies, substantial heterogeneity in PRP preparation techniques and absence of validated pediatric protocols were observed.
Discussion and conclusions. Findings suggest that PRP is safe and potentially effective for complex wounds and postoperative recovery in neonates and children, especially when conventional treatments are insufficient. However, methodological variability, small sample sizes, and the lack of standardized pediatric protocols limit comparability and clinical implementation. Pediatric-specific challenges – such as limited blood volume, venipuncture difficulty, and risks of iatrogenic anemia – further underline the need for tailored approaches. High-quality, prospective pediatric studies and validated clinical protocols are required to support evidence-based adoption.
References
1. Attinger CE, Janis JE, Steinberg J, Schwartz J, Al-Attar A, Couch K. Clinical approach to wounds: debridement and wound bed preparation including the use of dressings and wound-healing adjuvants. Plast Reconstr Surg. 2006;117(7 Suppl):72S-109S. https://doi.org/10.1097/01.prs.0000222565.07104.64
2. Chetter IC, Oswald AV, McGinnis E, Stubbs N, Bosanquet DC, Young H, et al. Patients with surgical wounds healing by secondary intention: a prospective, cohort study. Int J Nurs Stud. 2019;89:62-71. https://doi.org/10.1016/j.ijnurstu.2018.09.011
3. Sandy-Hodgetts K, Carville K, Leslie GD. Determining risk factors for surgical wound dehiscence: a literature review. Int Wound J. 2013;12(3):265-275. https://doi.org/10.1111/iwj.12088
4. Etulain J. Platelets in wound healing and regenerative medicine. Platelets. 2018;29(6):556-568. https://doi.org/10.1080/09537104.2018.1430357
5. Everts PA, Knape JT, Weibrich G, Schönberger JP, Hoffmann J, Overdevest EP, et al. Platelet-rich plasma and platelet gel: a review. J Extra Corpor Technol. 2006;38(2):174-187. https://doi.org/10.52547/ject.38.2.174
6. Collins T, Alexander D, Barkatali B. Platelet-rich plasma: a narrative review. EFORT Open Rev. 2021;6(4):225-235. https://doi.org/10.1302/2058-5241.6.200017
7. Bielefeld KA, Amini-Nik S, Alman BA. Cutaneous wound healing: recruiting developmental pathways for regeneration. Cell Mol Life Sci. 2013;70(12):2059-2081. https://doi.org/10.1007/s00018-012-1152-9
8. Landén NX, Li D, Ståhle M. Transition from inflammation to proliferation: a critical step during wound healing. Cell Mol Life Sci. 2016;73(20):3861-3886. https://doi.org/10.1007/s00018-016-2268-0
9. Takagi N, Kawakami K, Kanno E, Tanno H, Takeda A, Ishii K, et al. IL-17A promotes neutrophilic inflammation and disturbs acute wound healing in skin. Exp Dermatol. 2017;26(2):137-144. https://doi.org/10.1111/exd.13115
10. Xue M, Jackson CJ. Extracellular matrix reorganization during wound healing and its impact on abnormal scarring. Adv Wound Care. 2015;4(3):119-136. https://doi.org/10.1089/wound.2013.0485
11. Harrison P. The use of platelets in regenerative medicine and proposal for a new classification system: guidance from the SSC of the ISTH. J Thromb Haemost. 2018;16(9):1895-1900. https://doi.org/10.1111/jth.14223
12. Magalon J, Chateau AL, Bertrand B, et al. DEPA classification: a proposal for standardising PRP use and a retrospective application of available devices. BMJ Open Sport Exerc Med. 2016;2(1):e000060. https://doi.org/10.1136/bmjsem-2015-000060
13. Dashore S, Chouhan K, Nanda S, Sharma A. Preparation of Platelet-Rich Plasma: National IADVL PRP Taskforce Recommendations. Indian Dermatol Online J. 2021;12(Suppl 1):S12-S23. https://doi.org/10.4103/idoj.idoj_269_21
14. Nicolosi B, Carletti V, Certini M, Libro G, Ambretti E, Pavan P, Facchini F, Morabito A, Granai V. Platelet-rich plasma (PRP) for treating chronic or complicated wounds in neonates and children: a case series. Wounds UK. 2024;20(1):18-23.
15. Joshi AD, More SN, Mhambre AS. Treatment of a chronic, nonhealing neuropathic ulcer in a pediatric patient with spinal dysraphism: a case report. Wound Manag Prev. 2020;66(12):29-33. https://doi.org/10.25270/wmp.2020.12.2933
16. Mohseni R, et al. Cord blood platelet gel for refractory cutaneous ulcers in pediatric chronic graft-versus-host disease: a randomized clinical trial. Transplant Cell Ther. 2024;30(8). https://doi.org/10.1016/j.jtct.2024.04.021
17. Di Mitri M, D’Antonio S, Collautti E, Di Carmine A. Platelet-Rich Plasma in Pediatric Surgery: A Comprehensive Review. Children. 2024;11(8):984. https://doi.org/10.3390/children11080984
18. Pang C, Ibrahim A, Bulstrode NW, Ferretti P. An overview of the therapeutic potential of regenerative medicine in cutaneous wound healing. Int Wound J. 2017;14(3):450-459. https://doi.org/10.1111/iwj.12602
19. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19-32. https://doi.org/10.1080/1364557032000119616
20. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69. https://doi.org/10.1186/1748-5908-5-69
21. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA-ScR: checklist and explanation. Ann Intern Med. 2018;169(7):467-473. https://doi.org/10.7326/M18-0850
22. Sousa HM, Gonçalves V. Pediatric PRP/PRF procedural algorithm. J Wound Manag. 2024;25(Suppl):ePoster 424. https://journals.cambridgemedia.com.au/application/files/3417/2041/6818/EWMA_supplement_-_Conference_Abstracts.pdf
23. Van Ramshorst GH, Nieuwenhuizen J, Hop WC, Arends P, Lange JF, et al. Abdominal wound dehiscence in adults: development and validation of a risk model. World J Surg. 2010;34(1):20-27. https://doi.org/10.1007/s00268-009-0264-0
24. Latalski M, Walczyk A, Fatyga M, et al. Allergic reaction to platelet-rich plasma (PRP): case report. Medicine. 2019;98(10):e14702. https://doi.org/10.1097/MD.0000000000014702
25. Gibble JW, Ness PM. Fibrin glue: the perfect operative sealant? Transfusion. 1990;30(8):741-747. https://doi.org/10.1046/j.1537-2995.1990.30891366778.x
26. Ceydeli A, Rucinski J, Wise L. Finding the best abdominal closure: an evidence-based review. Curr Surg. 2005;62(2):220-225. https://doi.org/10.1016/j.cursur.2005.01.014
27. Rucinski J, Margolis M, Panagopoulos G, Wise L. Closure of the abdominal midline fascia: meta-analysis delineates the optimal technique. Am Surg. 2001;67(5):421-426. PMID:11383359
28. Schiavon M, Francescon M, Drigo D, Salloum D, et al. Use of Integra dermal regeneration template versus flaps for reconstruction of full-thickness scalp defects involving the calvaria: a cost-benefit analysis. Aesthetic Plast Surg. 2017;41(2):464-474. https://doi.org/10.1007/s00266-016-0736-6
29. Chetter IC, Oswald AV, McGinnis E, et al. Surgical wounds healing by secondary intention: nursing pathway. Int J Nurs Stud. 2019;89:62-71. https://doi.org/10.1016/j.ijnurstu.2018.09.011
30. Stark CM, Juul SE. New frontiers in neonatal red blood cell transfusion research. J Perinatol. 2023;43(11):1349-1356. https://doi.org/10.1038/s41372-023-01757-7
31. Howie SR. Blood sample volumes in child health research: review of safe limits. Bull World Health Organ. 2011;89(1):46-53. https://doi.org/10.2471/BLT.10.080010
32. American Academy of Pediatrics. Prevention and management of procedural pain in the neonate. Pediatrics. 2016;137(2):e20154271. https://doi.org/10.1542/peds.2016-1461
33. World Health Organization. WHO guidelines on drawing blood. Geneva: WHO; 2010. Available from: https://www.who.int/publications/i/item/9789241599221
34. Liu Y, Chen X. Neonatal skin structure and wound-healing physiology: implications for care. Pediatr Dermatol. 2019;36(4):431-440. https://doi.org/10.1111/pde.13797
35. Lavoie PM, Stritzke A, Ting JY, et al. Reducing neonatal procedural pain and stress. Semin Fetal Neonatal Med. 2017;22(5):274-281. https://doi.org/10.1016/j.siny.2017.07.001
36. Thacker JP, Shah DS, Patel DV, Nimbalkar SM. Practices of procedural pain management in neonates. Int J Pediatr. 2022;2022:8605071. https://doi.org/10.1155/2022/8605071
37. Corbett M, Marshall D, Harden M, O’Connor S, et al. Nurse-led advanced wound care: scope and outcomes. J Adv Nurs. 2020;76(7):1688-1702. https://doi.org/10.1111/jan.14339
38. Schultz GS, Sibbald RG, Falanga V, Ayello EA, Dowsett C, Harding K, et al. Wound bed preparation: a systematic approach. Wound Repair Regen. 2003;11(Suppl 1):S1-S28. https://doi.org/10.1046/j.1524-475x.11.s2.1.x
39. Leaper DJ, Schultz G, Carville K, Swanson T, Wolcott R, Tachi M. Implementing TIMERS: the race against hard-to-heal wounds. J Wound Care. 2019;28(Suppl 3):S1-S50. https://doi.org/10.12968/jowc.2019.28.Sup3a.S1
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