Platelet-rich plasma for wound healing and scar formation after cesarean section: a systematic review and meta-analysis of randomized controlled trials
Abstract
Background: Surgical wound complications follow 3-15% of cesarean deliveries globally. Platelet-rich plasma (PRP), an autologous concentrate of growth factors, has documented regenerative activity across several surgical disciplines, yet no quantitative synthesis of randomized trial evidence has been published for its intraoperative use during cesarean section.
Methods: PubMed/MEDLINE, Embase, CENTRAL, Scopus, and Web of Science were systematically searched from inception through March 2026 to identify randomized controlled trials comparing intraoperative PRP with standard care during cesarean section. Primary outcomes were skin scar quality measured with the Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale (VSS), or the Manchester Scar Scale; early wound inflammation measured with the Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scale; and uterine scar integrity defined by niche formation rate and residual myometrial thickness. Secondary outcomes were postoperative pain on visual analogue or numeric rating scales and analgesic consumption. Standardized mean differences (Hedges' g) were pooled using a DerSimonian-Laird random-effects model. Ambiguity regarding dispersion measures in one study was resolved through p-value back-calculation, and sensitivity analyses were pre-specified. The protocol was registered prospectively (INPLASY202640041; doi: https://doi.org/10.37766/inplasy2026.4.0041 ).
Results: Five randomized trials…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 366 participants or records.
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