title: Application of Autologous Platelet-Rich Plasma (PRP) on Wound Healing After Caesarean Section in High-Risk Patients.
abstract: BACKGROUND
  Platelet-rich plasma (PRP) is a human plasma product enriched by platelets, growth factors, and fibrinogen with high hemostatic and healing properties.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the effect of autologous PRP on wound healing in high-risk women undergoing cesarean sections.
  
  
  METHODS
  In this balanced, randomized, and controlled trial, 140 patients were admitted to Arash women's hospital, Tehran, Iran from May of 2013 to November of 2014 for elective cesarean surgery. The patients were randomly assigned into two groups. The intervention group received PRP after surgery, whereas the control group received the usual care. All patients were evaluated at baseline, five days, and eight weeks after the cesarean section. The primary endpoint used the REEDA scale for assessing the changes in wound healing. The secondary outcome measures used were the Vancouver scar scale (VSS) and the visual analog scale (VAS). All scale scores were analyzed using a repeated measures test for variance.
  
  
  RESULTS
  At the end of study, the PRP group showed a greater reduction in the edema ecchymosed discharge approximation (REEDA) score compared to the control group (85.5% reduction in the PRP group; 72% in the control group) (P < 0.001). Compared with the control group, the PRP group had a significantly greater reduction in the VAN score, beginning on the fifth day after the cesarean section (-0.7, 38% reduction in PRP group; -0.8, 33% in control group) (P < 0.001), and this trend was stable at the end of the eighth week (-0.6, 54% reduction in PRP group; -0.3, 18% in control group). Furthermore, patients treated with PRP experienced a 93% reduction in the VAS score at the end of follow-up, but the control group only observed a 79% reduction (P < 0.001).
  
  
  CONCLUSIONS
  It seems that applying PRP is an effective therapeutic approach for wound healing, and faster wound healing is expected due to the presence of more platelets and growth factors.
authors.affiliation: Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Afsaneh
authors.initials: A
authors.lastname: Tehranian
authors.affiliation: Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Bahareh
authors.initials: B
authors.lastname: Esfehani-Mehr
authors.affiliation: Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Reihaneh
authors.initials: R
authors.lastname: Pirjani
authors.affiliation: Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Negar
authors.initials: N
authors.lastname: Rezaei
authors.affiliation: Research Promotion Center, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Somaye
authors.initials: S
authors.lastname: Sadat Heidary
authors.affiliation: Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, IR Iran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Sepidarkish
keywords: Caesarean Section; Platelet-Rich Plasma; Wound Healing