Keywords
Foot Ulcer
Platelet-Rich Plasma
Platelet-Rich Fibrin
Wound Healing
Treatment Outcome
How to Cite
Abstract
Introduction. Platelet-rich plasma (PRP) has been investigated as an adjunctive therapy for diabetes-related foot ulcers, but heterogeneity in preparation and application protocols limits interpretation of the evidence. This review aimed to analyze current evidence on PRP, focusing on protocols, clinical effects, safety, and standardization gaps.
Methods. This systematic review with narrative synthesis followed PRISMA 2020, the Cochrane Handbook, and SWiM guidance. Searches were conducted between September and October 2025 in MEDLINE/PubMed, LILACS, BDENF, CUMED, the Cochrane Library, Web of Science, and Scopus. Primary human studies published from 2021 to 2025 evaluating PRP or related platelet-derived products were included. Two reviewers independently screened studies and extracted data. Meta-analysis was not performed because of substantial clinical and methodological heterogeneity.
Results. Of 907 records identified, 34 studies involving 3,597 participants were included. PRP was administered through different modalities, including dressings, gels, topical applications, injections, platelet-rich fibrin, and combinations with other wound-care technologies. Some studies reported favorable findings for complete ulcer closure, wound area or volume reduction, shorter healing time, granulation, re-epithelialization, and fewer local complications. Complete healing rates ranged from 55.3% to 95%, while healing time was most often between four and 16 weeks. However, methodological heterogeneity, moderate methodological quality, risk-of-bias concerns, and incomplete safety reporting limited interpretation of the findings.
Discussion. PRP showed potential as an adjunctive treatment for diabetes-related foot ulcers, with favorable findings for tissue regeneration and wound healing in several studies. Its minimally invasive nature and relatively simple application may support clinical feasibility. However, heterogeneity among protocols, risk of bias, and incomplete safety reporting preclude definitive conclusions regarding its clinical effectiveness and safety.
References
Armstrong, D. G., Boulton, A. J. M., & Bus, S. A. (2017). Diabetic foot ulcers and their recurrence. The New England Journal of Medicine, 376(24), 2367–2375. https://doi.org/10.1056/nejmra1615439
Arora, K. K., Kapila, R., Chaudhary, P., Singhal, A., Patra, A., & Kapila, S. (2022). Proficiency of topical platelet-rich plasma with vacuum-assisted closure over platelet-rich plasma alone in diabetic foot ulcers: A clinical, prospective, comparative study. Archives of Trauma Research, 11, 37–43. https://archtrauma.kaums.ac.ir/article_172942.html
Azam, M. S., Azad, M. H., Arsalan, M., Malik, A., Ashraf, R., & Javed, H. (2024). Efficacy of platelet-rich plasma in the treatment of diabetic foot ulcer. Cureus, 16(5). https://doi.org/10.7759/cureus.60934
Barker, T. H., Habibi, N., Aromataris, E., Stone, J. C., Leonardi-Bee, J., Sears, K., Hasanoff, S., Klugar, M., Tufanaru, C., Moola, S., & Munn, Z. (2024). The revised JBI critical appraisal tool for the assessment of risk of bias for quasi-experimental studies. JBI Evidence Synthesis, 22(3), 378–388. https://doi.org/10.11124/jbies-23-00268
Barker, T. H., Stone, J. C., Sears, K., Klugar, M., Tufanaru, C., Leonardi-Bee, J., Aromataris, E., & Munn, Z. (2023). The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI Evidence Synthesis, 21(3), 494–506. https://doi.org/10.11124/jbies-22-00430
Campbell, M., McKenzie, J. E., Sowden, A., Katikireddi, S. V., Brennan, S. E., Ellis, S., Hartmann-Boyce, J., Ryan, R., Shepperd, S., Thomas, J., Welch, V., & Thomson, H. (2020). Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline. BMJ, 368. https://doi.org/10.1136/bmj.l6890
Chen, P., Vilorio, N. C., Dhatariya, K., Jeffcoate, W., Lobmann, R., McIntosh, C., Piaggesi, A., Steinberg, J., Vas, P., Viswanathan, V., Wu, S., & Game, F. (2024). Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update). Diabetes/Metabolism Research and Reviews, 40(3). https://doi.org/10.1002/dmrr.3644
Chicharro-Alcántara, D., Rubio-Zaragoza, M., Damiá-Giménez, E., Carrillo-Poveda, J., Cuervo-Serrato, B., Peláez-Gorrea, P., & Sopena-Juncosa, J. (2018). Platelet rich plasma: New insights for cutaneous wound healing management. Journal of Functional Biomaterials, 9(1). https://doi.org/10.3390/jfb9010010
Das, S., Kumar, A., Kumar, S., Pandey, S. K., Kumar, N., & Kumar, R. (2024). Comparison between topical platelet-rich plasma and normal saline dressing in conjunction with total contact casting in treatment of diabetic foot ulcer: A randomized control trial. Indian Journal of Physical Medicine and Rehabilitation, 34(3), 212–217. https://doi.org/10.4103/ijpmr.ijpmr_43_24
Deng, J., Yang, M., Zhang, X., & Zhang, H. (2023). Efficacy and safety of autologous platelet-rich plasma for diabetic foot ulcer healing: A systematic review and meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research, 18(1). https://doi.org/10.1186/s13018-023-03854-x
Du, L., Zeng, D., Hu, X., Ren, X., & He, D. (2022). The efficacy of autologous platelet-rich gel and traditional Chinese medicine in diabetic foot treatment: A parallel randomized controlled clinical trial. Annals of Vascular Surgery, 87, 529–537. https://doi.org/10.1016/j.avsg.2022.07.026
El-Leithy, S. A. E., Adly, N. N., Taha, R. M., & El Gharbawy, N. H. (2023). Comparative effectiveness of extra-corporeal shock wave therapy, platelet rich plasma therapy and topical insulin therapy in diabetic foot ulcer healing. Revista Iberoamericana de Psicología del Ejercicio y el Deporte, 18, 102–105. https://dialnet.unirioja.es/servlet/articulo?codigo=8877182
Fibrini, D., & Lister, I. N. E. (2023). Pilot study on the effect of autologous activated platelet-rich plasma on diabetic foot ulcer healing and serum HbA1c levels. Journal of Pharmacy & Pharmacognosy Research, 11(2), 263–269. https://doi.org/10.56499/jppres22.1555_11.2.263
Gowsick, S., Balaji, D., Arul, Unnikrishnan, E. S., & Manish, R. (2023). Comparison of the efficacy of autologous platelet-rich plasma and saline dressing in healing of diabetic foot ulcer: A randomised control study. Journal of Clinical and Diagnostic Research, 17(5), PC17–PC22. https://doi.org/10.7860/jcdr/2023/60861.17987
Gupta, A., Channaveera, C., Sethi, S., Ranga, S., & Anand, V. (2021). Efficacy of intralesional platelet-rich plasma in diabetic foot ulcer. Journal of the American Podiatric Medical Association, 111(3), https://doi.org/10.7547/19-149
Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (Eds.). (2022). Cochrane handbook for systematic reviews of interventions (Version 6.3). Cochrane. https://www.cochrane.org/authors/handbooks-and-manuals/handbook/archive/v6.3
Hossam, E. M., Alserr, A. H. K., Antonopoulos, C. N., Zaki, A., & Eldaly, W. (2022). Autologous platelet rich plasma promotes the healing of non-ischemic diabetic foot ulcers: A randomized controlled trial. Annals of Vascular Surgery, 82, 165–171. https://doi.org/10.1016/j.avsg.2021.10.061
Huang, J., Sun, J., Wang, Q., Mo, J., Nong, Y., Zhai, Z., Huang, X., Mo, J., & Lu, W. (2023). A novel wound therapy modality: Autologous wound edge dotted full-thickness skin grafting improving diabetic foot ulcer healing. International Journal of General Medicine, 16, 3815–3827. https://doi.org/10.2147/ijgm.s427401
International Working Group on the Diabetic Foot. (2023). IWGDF guideline on interventions to enhance healing of foot ulcers in people with diabetes. https://iwgdfguidelines.org/wp-content/uploads/2023/07/IWGDF-2023-07-Wound-Healing-Guideline.pdf
Izzo, P., De Intinis, C., Molle, M., Polistena, A., Sibio, S., Codacci-Pisanelli, M., Biacchi, D., Di Cello, P., Santini, D., Izzo, L., & Izzo, S. (2023). The use of PRP in the treatment of diabetic foot: Case series and a review of the literature. Frontiers in Endocrinology, 14. https://doi.org/10.3389/fendo.2023.1286907
Jain, L., Sethy, M. K., Jena, A. K., Pattanaik, A., Mishra, R. K., Bhakta, M., & Behera, A. (2025). Efficacy of platelet-rich plasma dressing versus normal saline dressing in the management of diabetic foot ulcers: A comparative study conducted in a tertiary care hospital in Southern Odisha. Cureus, 17(6). https://doi.org/10.7759/cureus.87106
Jain, S., Jain, A., & Malik, S. (2024). Improved healing and reduced complications with PRP therapy for diabetic foot ulcers. Journal of Cardiovascular Disease Research, 15, 1–5. https://jcdronline.org/index.php/JCDR/article/view/3370
Jin, Y., Meng, M. Y., Zhang, Y. F., Mo, L., Gao, H., Liu, Y. H., Wu, J., Yang, P. F., Zhang, Z. Z., Jia, F., Zhao, Y. Y., & Huang, Y. (2024). Comparative study on the efficacy of PRP gel and UC-MSCs gel as adjuvant therapies in the treatment of DFU wounds. Skin Research and Technology, 30(1). https://doi.org/10.1111/srt.13549
Joanna Briggs Institute. (2014). JBI levels of evidence. https://jbi.global/sites/default/files/2019-05/JBI-Levels-of-evidence_2014_0.pdf
Kamineni, R., & Tupkar, G. (2023). Efficacy of platelet rich plasma dressing versus normal saline dressing in the management of diabetic foot ulcers. International Journal of Pharmaceutical and Clinical Research, 15, 237–242. http://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue3,Article33.pdf
Kanber, E. M., & Gulmez, H. (2023). Factors affecting platelet-rich plasma success in patients with diabetic foot ulcer. Cureus, 15(6). https://doi.org/10.7759/cureus.40803
Kim, S.-A., Ryu, H.-W., Lee, K.-S., & Cho, J.-W. (2013). Application of platelet-rich plasma accelerates the wound healing process in acute and chronic ulcers through rapid migration and upregulation of cyclin A and CDK4 in HaCaT cells. Molecular Medicine Reports, 7(2), 476–480. https://doi.org/10.3892/mmr.2012.1230
Lambadiari, V., Kountouri, A., Psahoulia, F., Koliou, G.-A., Lazaris, A., Michalopoulos, E., Mallis, P., Korakas, E., Eleftheriadou, I., Balampanis, K., Sarris, M., Tsirigotis, P., Geroulakos, G., Stavropoulos-Giokas, C., Dimitriadis, G. D., & Tentolouris, N. (2024). Treatment with umbilical cord blood platelet lysate gel improves healing of diabetic foot ulcer. Journal of Clinical Medicine, 13(5). https://doi.org/10.3390/jcm13051310
Lizarondo, L., Stern, C., Carrier, J., Godfrey, C., Rieger, K., Salmond, S., Apostolo, J., Kirkpatrick, P., & Loveday, H. (2024). Mixed methods systematic reviews. In E. Aromataris, C. Lockwood, K. Porritt, B. Pilla, & Z. Jordan (Eds.), JBI manual for evidence synthesis. JBI. https://doi.org/10.46658/JBIMES-24-07
Malekpour Alamdari, N., Shafiee, A., Mirmohseni, A., & Besharat, S. (2021). Evaluation of the efficacy of platelet-rich plasma on healing of clean diabetic foot ulcers: A randomized clinical trial in Tehran, Iran. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 15(2), 621–626. https://doi.org/10.1016/j.dsx.2021.03.005
Mandadap, S. (2022). Conventional dressing versus platelet rich plasma in the management of diabetic foot ulcers: A prospective comparative study. International Journal of Pharmaceutical and Clinical Research, 14, 329–333. https://impactfactor.org/PDF/IJPCR/14/IJPCR%2CVol14%2CIssue11%2CArticle47.pdf
Marram, M. F. U., Khan, W. A., Imran, M., Umer, W., Deen, Z. M. U., & Malik, F. N. (2025). Role of autologous platelet rich plasma in timely healing of chronic diabetic foot ulcer. Pakistan Armed Forces Medical Journal, 75(2), 369–373. https://doi.org/10.51253/pafmj.v75i2.11669
Meamar, R., Ghasemi-Mobarakeh, L., Norouzi, M.-R., Siavash, M., Hamblin, M. R., & Fesharaki, M. (2021). Improved wound healing of diabetic foot ulcers using human placenta-derived mesenchymal stem cells in gelatin electrospun nanofibrous scaffolds plus a platelet-rich plasma gel: A randomized clinical trial. International Immunopharmacology, 101. https://doi.org/10.1016/j.intimp.2021.108282
Melnyk, B. M., & Fineout-Overholt, E. (2005). Making the case for evidence-based practice. In B. M. Melnyk & E. Fineout-Overholt (Eds.), Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Moola, S., Munn, Z., Tufanaru, C., Aromataris, E., Sears, K., Sfetcu, R., Currie, M., Qureshi, R., Mattis, P., Lisy, K., & Mu, P. F. (2020). Systematic reviews of etiology and risk. In E. Aromataris & Z. Munn (Eds.), JBI manual for evidence synthesis. JBI. https://synthesismanual.jbi.global
Munn, Z., Barker, T. H., Moola, S., Tufanaru, C., Stern, C., McArthur, A., Stephenson, M., & Aromataris, E. (2020). Methodological quality of case series studies: An introduction to the JBI critical appraisal tool. JBI Evidence Synthesis, 18(10), 2127–2133. https://doi.org/10.11124/jbisrir-d-19-00099
Muthu, S., Krishnan, A., & Ramanathan, K. R. (2022). Standardization and validation of a conventional high yield platelet-rich plasma preparation protocol. Annals of Medicine and Surgery, 82. https://doi.org/10.1016/j.amsu.2022.104593
Nasr, M., El-Nawasany, M. A. H., Ali, H. E., El Nagar, A. E., Elsharawy, A. F., Mirdad, D. S. A., Baloush, R. A. A., Majrashi, M. A., Elkaseer, M. H., Abdel-maksoud, M. A., Mahmoud, M. O., Mohammed, Z. F., Ibrahim, H. S. A., Mohammed, T. S., Hasan, A., Hegab, A. Y., Alaghbari, K. A. A., Abbas, M., Abood, H. B. A., & Hablas, M. G. A. (2025). Effectiveness of injected versus topically applied platelet-rich plasma in diabetic foot ulcers: A randomized controlled trial with clinical and histopathological assessment. JPRAS Open, 46, 22–32. https://doi.org/10.1016/j.jpra.2025.08.008
Ohura, N., Kimura, C., Ando, H., Yuzuriha, S., Furukawa, M., Higashita, R., Ayabe, S., Tsuji, Y., Fujii, M., Terabe, Y., Sakisaka, M., Iwashina, Y., Nakanishi, A., Sasaki, S., Hasegawa, T., Kawauchi, T., & Hisamichi, K. (2024). Efficacy of autologous platelet-rich plasma gel in patients with hard-to-heal diabetic foot ulcers: A multicentre study in Japan. Journal of Wound Care, 33(7), 484–494. https://doi.org/10.12968/jowc.2023.0088
Orban, Y., Soliman, M., Hegab, Y., & Alkilany, M. (2022). Autologous platelet-rich plasma vs conventional dressing in the management of chronic diabetic foot ulcers. Wounds, 34(2), 36–42. https://doi.org/10.25270/wnds/2022.3642
OuYang, H., Tang, Y., Yang, F., Ren, X., Yang, J., Cao, H., & Yin, Y. (2023). Platelet-rich plasma for the treatment of diabetic foot ulcer: A systematic review. Frontiers in Endocrinology, 14. https://doi.org/10.3389/fendo.2023.1256081
Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016). Rayyan: A web and mobile app for systematic reviews. Systematic Reviews, 5(1). https://doi.org/10.1186/s13643-016-0384-4
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., . . . Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372. https://doi.org/10.1136/bmj.n71
Patel, P. R., Shah, K., Vasaiya, M. K. K., & Modi, K. C. (2023). Efficacy and safety of PRP in the treatment of diabetic foot ulcers. International Journal of Toxicological and Pharmacological Research, 13, 95–99. https://impactfactor.org/PDF/IJTPR/13/IJTPR%2CVol13%2CIssue10%2CArticle19.pdf
Peng, Y., Wang, J. P., Liu, X., Zhou, Y., Jia, S., Xu, J., & Zheng, C. (2024). Efficacy of platelet-rich plasma in the treatment of diabetic foot ulcers: A systematic review and meta-analysis. Annals of Vascular Surgery, 98, 365–373. https://doi.org/10.1016/j.avsg.2023.05.045
Rajendran, S., Thiyagarajan, M., Singh, B., & Navrathan, N. (2021). A comparative study on effect of platelet rich plasma vs conventional dressing in healing rate of chronic diabetic ulcers. Biomedicine, 41, 849–854. https://biomedicineonline.org/article/a-comparative-study-on-effect-of-platelet-rich-plasma-vs-conventional-dressing-in-healing-rate-of-chronic-diabetic-ulcers/
Rani, D. A., Khanna, S., Mishra, S. P., & Kumar, S. (2023). A comparative evaluation of topical application versus perilesional injection of platelet-rich plasma in diabetic foot ulcer. The International Journal of Lower Extremity Wounds. Advance online publication. https://doi.org/10.1177/15347346231176727
Russo, S., Landi, S., & Courric, S. (2022). Cost-effectiveness analysis for the treatment of diabetic foot ulcer in France: Platelet-rich plasma vs standard of care. ClinicoEconomics and Outcomes Research, 14, 1–10. https://doi.org/10.2147/ceor.s327191
Russo, S., Landi, S., & Simoni, S. (2025). Cost-effectiveness analysis for managing diabetic foot ulcer (DFU) in USA: Platelet-rich plasma (PRP) vs standard of care (SoC). ClinicoEconomics and Outcomes Research, 17, 157–169. https://doi.org/10.2147/ceor.s496616
Saad, H. A., Yehia, A. M., & Osman, G. (2022). The effect of platelet rich plasma (PRP) injection to the wound compared to PRP gel local application compared to classic dressing on diabetic foot healing ulcer. Surgery Research, 4, 1–7. https://www.scivisionpub.com/pdfs/the-effect-of-platelet-rich-plasma-prp-injection-to-the-wound-compared-to-prp-jel-local-application-compared-to-classic-dressing-o-2433.pdf
Sheng, X., Hu, L., Li, T., Zou, Y., Fu, H.-Y., Xiong, G.-P., Zhu, Y., Deng, B., Xiong, L.-L., & Yin, X.-L. (2024). Clinical efficacy and mechanism of the combination of autologous platelet-rich gel and recombinant human acidic fibroblast growth factor in the management of refractory diabetic foot. Frontiers in Endocrinology, 15. https://doi.org/10.3389/fendo.2024.1374507
Smith, J., & Rai, V. (2024). Platelet-rich plasma in diabetic foot ulcer healing: Contemplating the facts. International Journal of Molecular Sciences, 25(23). https://doi.org/10.3390/ijms252312864
Sterne, J. A. C., Hernán, M. A., Reeves, B. C., Savović, J., Berkman, N. D., Viswanathan, M., Henry, D., Altman, D. G., Ansari, M. T., Boutron, I., Carpenter, J. R., Chan, A.-W., Churchill, R., Deeks, J. J., Hróbjartsson, A., Kirkham, J., Jüni, P., Loke, Y. K., Pigott, T. D., . . . Higgins, J. P. T. (2016). ROBINS-I: A tool for assessing risk of bias in non-randomized studies of interventions. BMJ, 355. https://doi.org/10.1136/bmj.i4919
Sterne, J. A. C., Savović, J., Page, M. J., Elbers, R. G., Blencowe, N. S., Boutron, I., Cates, C. J., Cheng, H.-Y., Corbett, M. S., Eldridge, S. M., Emberson, J. R., Hernán, M. A., Hopewell, S., Hróbjartsson, A., Junqueira, D. R., Jüni, P., Kirkham, J. J., Lasserson, T., Li, T., . . . Higgins, J. P. T. (2019). RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ, 366. https://doi.org/10.1136/bmj.l4898
Syafira, F., Iman, M. B., Pariyana, & Sriwulandari, R. (2024). Platelet-rich plasma (PRP) as therapy for diabetic foot ulcer (DFU): A systematic review and meta-analysis of the latest randomized controlled trials. Diabetes Epidemiology and Management, 13. https://doi.org/10.1016/j.deman.2023.100178
Tabanjeh, S. F., Al-Malki, T., Kharabsheh, R. A., & Mahmood, D. (2023). A case series of autologous platelet-rich plasma injection in treating chronic ulcers conducted in Saudi Arabia. International Journal of Health Sciences, 17, 46–56. https://pubmed.ncbi.nlm.nih.gov/36891041/
Ullah, A., Jawaid, S. I., Qureshi, P. N. A. A., Siddiqui, T., Nasim, K., Kumar, K., Ullah, S., Sajjad Cheema, M., Kumari, N., & Elias, H. A. (2022). Effectiveness of injected platelet-rich plasma in the treatment of diabetic foot ulcer disease. Cureus, 14(8). https://doi.org/10.7759/cureus.28292
Vannan, K. M., & Sivapriya, A. (2024). Clinical study of therapeutic role of platelet rich plasma in healing of diabetic foot ulcers. Research Journal of Medical Sciences, 18, 83–87. https://makhillpublications.co/files/published-files/mak-rjms/2024/83-87.pdf
Verma, R., Kumar, S., Garg, P., & Verma, Y. K. (2023). Platelet-rich plasma: A comparative and economical therapy for wound healing and tissue regeneration. Cell and Tissue Banking, 24(2), 285–306. https://doi.org/10.1007/s10561-022-10039-z
Wang, Y., Liu, B., Pi, Y., Hu, L., Yuan, Y., Luo, J., Tao, Y., Li, P., Lu, S., & Song, W. (2022). Risk factors for diabetic foot ulcers mortality and novel negative pressure combined with platelet-rich plasma therapy in the treatment of diabetic foot ulcers. Frontiers in Pharmacology, 13. https://doi.org/10.3389/fphar.2022.1051299
Wilkinson, H. N., & Hardman, M. J. (2020). Wound healing: Cellular mechanisms and pathological outcomes. Open Biology, 10(9). https://doi.org/10.1098/rsob.200223
Xu, H., Huang, K., & Tao, X. (2025). Efficacy and safety of platelet-rich plasma versus conventional care in diabetic foot ulcers: A meta-analysis of randomized controlled trials. Acta Diabetologica, 62(10), 1585–1596. https://doi.org/10.1007/s00592-025-02555-7
Zhang, P., Lu, J., Jing, Y., Tang, S., Zhu, D., & Bi, Y. (2017). Global epidemiology of diabetic foot ulceration: A systematic review and meta-analysis. Annals of Medicine, 49(2), 106–116. https://doi.org/10.1080/07853890.2016.1231932
Zhen, P.-X., Su, H.-J., Yang, S.-J., Chen, X., Lin, Z.-M., & Liu, S.-N. (2025). Comparison of clinical efficacy between tibial cortex transverse transport and platelet-rich plasma treatment for severe diabetic foot ulcers. Frontiers in Surgery, 12. https://doi.org/10.3389/fsurg.2025.1507982
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