A platelet rich plasma for pilonidal sinus disease (systematic review and meta-analysis)

AIM: to compare the efficacy (wound healing) and safety (wound infection) between traditional treatment after open access for pilonidal sinus (PS) and with use of platelet-rich plasma (PRP).

MATERIAL AND METHODS: a systematic review and meta-analysis of clinical research data was conducted to compare lay — open method with the use of PRP and lay — open method without the use of PRP for the treatment of PS. The meta-analysis included 4 randomized clinical trials and obtained data on the results of treatment of 299 patients. However, almost all the publications show a high risk of bias in their results.

RESULTS: the meta-analysis revealed a statistically significant revealed of lay — open method with the use of PRP in reducing wound area on days 10 (MD = 3.68, 95% СI: 3.29–4,06, p < 0.00001), 15 (MD = 5.73, 95% СI: 2.94–8.53, p < 0.00001) and 20 (MD = 6.62, 95% СI: 6.14–7.10, p < 0,00001) after surgery, as well as reducing wound healing time (MD = 19.01, 95% CI: 6.40–31.63, p < 0.000001) and pain duration (MD = 10.46, 95% СI: 2.20–18.72, p < 0.00001), and a shorter period of return to work (MD = 12.80, 95% CI: 3.62–21.98, p < 0,00001) compared with the lay — open method without the use of PRP for the treatment of PS. There was no significant difference in the incidence of wound infection between the two comparison groups (MD = 3.92, 95% CI: 1.01–15.22, p = 0.05).

CONCLUSION: topical application of PRP in combination with pilonidal sinus excision followed by open wound management represents an effective and safe treatment approach for chronic inflammation in pilonidal sinus disease. Due to the high heterogeneity of the analyzed data, as well as the poor quality of studies included in meta-analyses, it is essential to treat results with caution. Further randomized controlled trials are needed to avoid incorrect conclusions.

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