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The Safety and Efficacy of Platelet-Rich Plasma in Enhancing Outcomes Following Circumcision in Children
Tahsin Onat Kamci1,2,3, Mustafa Azizoglu2,4,5, Sergey Klyuev2,6
1Department of Pediatric Surgery, Tatvan State Hospital, 13200 Bitlis, Turkey.
Insights
Platelet-rich plasma (PRP) therapy applied during pediatric circumcision is safe and may reduce pain and edema. This preliminary study suggests potential benefits for wound healing in male children undergoing the procedure.
Area of Science:
- Regenerative Medicine
- Pediatric Surgery
- Wound Healing
Background:
- Platelet-rich plasma (PRP) therapy utilizes growth factors to accelerate wound healing by 30-40%.
- PRP contains PDGF, TGF-β1, IGF-1, VEGF, FGF-2, and interleukins (IL-1, IL-4, IL-6, IL-10, IL-13).
- The study investigates PRP's role in enhancing outcomes of pediatric circumcision.
Purpose of the Study:
- To assess the safety and efficacy of platelet-rich plasma (PRP) in pediatric circumcision.
- To evaluate PRP's impact on pain, edema, bleeding, and infection rates post-circumcision.
Main Methods:
- 80 male children undergoing circumcision were divided into two groups: standard circumcision (CS) and PRP application (PRP).
- Evaluated outcomes included pain scores, edema, bleeding, local infection, and overall safety.
- Data was collected and compared between the CS and PRP groups.
Main Results:
- The PRP group showed lower incidence of penile edema (5.6% vs. 18.2%) and no postoperative bleeding.
- Pain scores were consistently lower in the PRP group compared to the CS group.
- No significant differences in other complications like nausea, vomiting, infection, or wound dehiscence were observed between groups. Safety analysis revealed minor, transient adverse events during blood draw and PRP application.
Conclusions:
- Platelet-rich plasma (PRP) application is safe for pediatric circumcision.
- PRP demonstrates potential benefits in reducing pain and edema, supporting wound healing.
- Further research is warranted to confirm these preliminary findings on PRP in pediatric circumcision.
Abstract:
Background: The primary objectives of platelet-rich plasma (PRP) therapy are to enhance the wound-healing process, reduce pain, and minimize the loss of productivity due to recovery time. Localized application of PRP, which is enriched with growth factors such as PDGF, TGF-β1, IGF-1, VEGF, and FGF-2, as well as interleukins (IL-1, IL-4, IL-6, IL-10, and IL-13), has been documented to accelerate the healing process by approximately 30-40%. This study aimed to assess the safety and efficacy of platelet-rich plasma (PRP) in enhancing outcomes following circumcision in male children. Methods: The patients were divided into two groups: one undergoing standard circumcision and the other receiving PRP application during circumcision. Pain scores, edema level, bleeding, local infection, and safety of PRP were evaluated. Results: This study evaluated 80 male children undergoing circumcision, divided into two groups: Group CS (n = 44) underwent classical circumcision, and Group PRP (n = 36) received PRP application. Median ages were comparable (p = 0.101). Penile edema occurred less frequently in the PRP group (5.6%) compared to the CS group (18.2%) (p = 0.089), with no severe edema observed in the PRP group. Postoperative bleeding was present in 6.8% of the CS group but absent in the PRP group (p = 0.110). Other complications, such as nausea (CS: 6.8%, PRP: 5.6%, p = 0.816), vomiting (CS: 4.5%, PRP: 2.8%, p = 0.679), local infection (CS: 2.3%, PRP: 0%, p = 0.363), wound dehiscence (CS: 2.3%, PRP: 0%, p = 0.363), and skin tunnel formation (CS: 6.8%, PRP: 2.8%, p = 0.409), showed no significant differences. No cases of necrosis, chordee, rotational anomaly, or secondary phimosis were observed. Safety analysis of PRP revealed minor complications during blood draw: hypotension in one patient (2.8%) and local ecchymosis in two patients (5.6%), resolving without intervention. During PRP application, one allergic reaction (2.8%) occurred, presenting as a transient rash that resolved spontaneously. Group PRP consistently reported lower pain scores than Group CS at all time points. Conclusions: PRP application during circumcision is safe. The findings provide preliminary but important evidence regarding the potential benefits of PRP in pediatric circumcision.
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