Efficacy of mesenchymal stem cells and platelet-rich plasma therapies on wound healing: A Systematic Review and meta-analysis

Background: Wound healing is a complex physiological process essential for maintaining tissue integrity and function. This meta-analysis aims to evaluate the efficacy of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP), and their combination in enhancing wound healing. Methods: We conducted a systematic search of PubMed, Web of Science, and Scopus databases for studies published from 2010 to 2024. The inclusion criteria were randomized controlled trials (RCTs) and controlled clinical trials involving human subjects treated with MSCs, PRP, or both. The primary outcomes assessed were wound closure rates and mean healing times, while secondary outcomes included wound size reduction, pain management, infection rates, recurrence, adverse events, and costeffectiveness. Data were pooled using STATA software version 17.0, with standardized mean differences (SMDs) and risk differences (RDs) calculated. Results: A total of 34 studies involving 2458 patients were included. PRP and MSCs significantly reduced wound healing time (PRP: SMD =-1.08, 95 % CI: 1.75 to-0.42, p <0.001; MSCs: SMD =-1.7195 %, CI: 2.44 to-0.99, p < 0.001). MSCs positively impacted new vessel development (overall SMD = 0.55, 95 % CI: 0.39 to 0.71, p < 0.001). PRP-treated groups had higher ulcer healing rates (72.4% vs 52.5 %, RD = 0.21, 95 % CI: 0.16 to 0.26, p < 0.001). Infection rates showed no statistically significant difference between PRP and control groups (DR =-0.11, 95 % CI: 0.34 to 0.12, p > 0.05), while rest pain scores were significantly lower in PRP-treated patients (SMD =-4.69, 95 % CI: 0.87 to-0.62, p = 0.02). PRP-treated ulcers had lower recurrence rates (RD =-0.14, 95 % CI: 0.75 to 0.97, p = 0.01). Conclusions: The findings from this meta-analysis underscore the promising potential of PRP and MSCs as effective therapeutic strategies for wound healing when used individually. (c) 2025 The Author(s). Published by Elsevier BV on behalf of The Japanese Society for Regenerative Medicine.