Cord Blood Platelet-Rich Plasma potentially promotes wound healing following cesarean section: Study
Cesarean section, a surgical procedure for delivering a baby through an incision made in the mother’s abdomen, is generally employed when serious problems prevent vaginal delivery. While cesarean delivery is relatively safe, it still carries risks such as infection, blood loss, internal organ injury, and complications from anesthesia. Surgical scars and wound pain are also common issues associated with this procedure. Most women experience pain for the first few days after a cesarean, and for some, the pain can persist for several weeks.
Wound healing involves a complex process aimed at restoring the barrier. During this process, the migration, infiltration, proliferation, and differentiation of various cell types, including keratinocytes, fibroblasts, endothelial cells, macrophages, and platelets, occur, resulting in inflammation, proliferation, and tissue remodeling. A complex signaling network involving numerous growth factors and cytokines plays an important role in regulating this complex process.
Platelet-rich plasma (PRP) is centrifuged fresh human blood with high concentrations of platelets, containing many growth factors, cytokines, and anti-inflammatory factors, including epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), insulin-like growth factor-1 (IGF-1), and tumor necrosis factor-alpha (TNF-α) interleukins and interferons. These growth factors and cytokines are believed to stimulate natural healing mechanisms, repair damaged tissue, and restore normal function; therefore, they accelerate the wound-healing process and may relieve pain at the site of PRP injection.
The clinical application of PRP has expanded to gynecological disorders such as refractory endometrium, Asherman’s syndrome, poor ovarian response, female sexuality, and urinary incontinence. It has been introduced to reduce the risk of wound dehiscence, wound infection, and scar formation and to improve wound healing in patients undergoing cesarean sections.
Platelet-rich plasma (PRP) promotes the wound-healing process and reduces pain. Cord blood platelet-rich plasma (CB-PRP), which can be easily collected from the umbilical cord and reapplied to a cesarean section wound, has been proposed to have similar effects as PRP. This paper hypothesized that CB-PRB would provide beneficial effects in terms of wound healing and pain reduction in women undergoing cesarean section.
This study was a randomized controlled trial involving 52 pregnant women who underwent cesarean sections. Participants were assigned to either the intervention group (n = 26) or the control group (n = 26) at the Obstetrics and Gynecology Clinic of Police General Hospital. Cord blood PRP was applied to the subcutaneous layer and the surgical wound immediately following the cesarean section. The efficacy of wound healing was evaluated using the REEDA scale score on days 1 and 3 postoperatively, and the Vancouver Scar Scale (VSS) was assessed in the 8th week postoperation. The efcacy in reducing pain was measured using a Visual Analog Scale on days 1 and 3 postoperatively. The mean REEDA scale on day 1 (mean ± SD: 1.5 ± 0.2561.5 ± 0.256 in the CB-PRP group and 2.5 ± 0.267 in the control group; p = 0.009) and the mean VSS score at the 8th week (mean ± SD: 2.577 ± 2.003 in the CB-PRP group and 6.962 ± 2.441 in the control group; p < 0.001) were significantly lower in the CB-PRP group than those in the control group. However, there were no differences in Visual Analog Scale values between the two groups.
This study demonstrates that the application of CB-PRP in cesarean section wounds potentially improves wound healing and scar formation, as evidenced by a significant reduction in REEDA score and VVS at days 1 and 8 weeks. Thus, it could be implied that CB-PRP enhances healing at the surgical site shortly after surgery and positively affects skin restoration at least 2 months later. The effect is attributed to various growth factors and cytokines that play a crucial role in every phase of the wound-healing process, along with increased fibroblast activity.
CB-PRP is an innovative therapeutic modality with a promising effect on improving wound healing and scar formation. It is affordable, simple, easy to perform, and has no serious adverse effects; however, due to the limited number of studies, more research is needed to confirm the beneficial effects of CB-PRP in the future.
Source: Amornrat Tanachaiviwat et al.; Wiley Obstetrics and Gynecology International Volume 2024, Article ID 4155779, 8 pages https://doi.org/10.1155/ogi/4155779
