PRP and Wound Healing | Clinical Application & Evidence

Sep 30, 2025

Oscar Tellez

PRP and Wound Healing: Clinical Use, Mechanisms, and Application in Difficult Tissue Repair

Chronic and non-healing wounds remain a persistent clinical challenge — particularly in patients with diabetes, vascular insufficiency, or delayed postoperative recovery. For physicians managing these complex cases, PRP and wound healing has become a point of growing interest.

Platelet-rich plasma (PRP) introduces a concentration of the patient’s own growth factors, plasma proteins, and signaling molecules directly into the wound environment. While not a replacement for surgical or antimicrobial strategies, PRP offers a biologically active adjunct that can modulate inflammation, promote angiogenesis, and support granulation tissue formation in otherwise stagnant wounds.

This blog outlines how PRP supports wound healing on a cellular level, which patients may benefit most, and how to apply it safely and effectively using validated systems.

Understanding PRP in the Context of Wound Healing

To explore the link between PRP and wound healing, it's important to first consider the wound healing process itself. Normal healing involves three overlapping phases:

Inflammation — cellular debris is cleared and immune cells respond
Proliferation — fibroblasts, endothelial cells, and keratinocytes begin to rebuild tissue
Remodeling — collagen is reorganized, and tensile strength improves

Chronic wounds often stall in the inflammatory phase. In these cases, PRP can help redirect the process by introducing concentrated biologic signals derived from the patient’s own platelets and plasma proteins.

What’s Inside PRP That Impacts Wound Repair?

Clinicians using PRP and wound healing protocols are essentially delivering a biologic dose of:

Platelet-Derived Growth Factor (PDGF) – Stimulates fibroblast activity and matrix production
Vascular Endothelial Growth Factor (VEGF) – Encourages capillary formation
Transforming Growth Factor-Beta (TGF-β) – Regulates inflammation and ECM remodeling
Epidermal Growth Factor (EGF) – Aids in epithelial migration and closure
Fibrin and Plasma Proteins – Act as scaffolds for cellular migration

These molecules are not added synthetically — they’re naturally present in whole blood but concentrated through centrifugation and separation protocols. This is why using a validated PRP system with consistent yield is critical.

How PRP Works in Wound Tissue

When applied to a wound bed, PRP initiates a localized regenerative response by:

Activating fibroblasts and keratinocytes
Promoting angiogenesis to restore perfusion
Modulating excess inflammation in chronic wounds
Stimulating matrix deposition for tissue strength
Supporting epithelialization across wound margins

This multifactorial effect is why PRP and wound healing have been investigated for use in:

Diabetic foot ulcers
Post-surgical incisions with delayed closure
Pressure injuries
Radiation-induced skin breakdown
Traumatic soft tissue injuries

PRP doesn’t replace debridement or infection control but supports biologic healing when those foundations are already addressed.

Clinical Application: Injection vs. Topical

There are two common ways to apply PRP in wound care:

1. Topical PRP Gel or Clot

Delivered directly to the wound surface
Typically mixed with calcium chloride or thrombin to induce clotting
Covered with a dressing to maintain contact
Useful for shallow or superficial wounds
May be repeated every 5–7 days as part of wound care cycles

2. PRP Injection Around Wound Margins

Delivered into the periphery or base of the wound
Stimulates fibroblast and capillary ingrowth
Requires careful sterile technique
Preferred for deeper or undermined wounds
Can be combined with topical PRP in complex cases

For physicians exploring PRP and wound healing, technique selection depends on wound type, depth, and the presence of infection or necrosis. In some settings, alternating between topical and injectable methods may enhance outcomes, especially in mixed-etiology wounds.

Choosing the Right PRP System for Wound Use

Unlike musculoskeletal injections, wound applications often require a larger volume of PRP and the ability to control whether the end product remains liquid or forms a clot.

A validated PRP system is essential to ensure:

Sterile, closed preparation to avoid contamination
Consistent platelet concentration (typically 4–6x baseline)
Low to moderate leukocyte content, depending on wound type
Compatibility with clot activators if using PRP as a gel
Clear spin settings and separation protocol for reproducibility

Systems like the Horizon 6 Flex centrifuge and PRP kits provided through Accretion Portal support these needs with validated protocols and safety documentation.

Limitations and Clinical Considerations

While the relationship between PRP and wound healing is promising, it’s not universally effective. PRP is unlikely to succeed in wounds with:

Active infection or exposed hardware
Thick eschar or necrotic tissue that hasn't been debrided
Severe vascular compromise that hasn't been corrected
Uncontrolled systemic conditions (e.g., hyperglycemia, malnutrition)
Hematologic disorders affecting platelet function

Additionally, patient-specific variables — such as age, platelet count, and comorbidities — influence response. Physicians should view PRP as part of a comprehensive wound protocol, not a standalone fix.

Documentation, baseline wound measurements, and photo tracking are useful for evaluating progress when PRP is added to care.

Storage and Handling for Optimal Performance

PRP is time-sensitive. To maintain platelet viability and biologic activity:

Use within 30–60 minutes of preparation
Avoid refrigeration or freezing
Mix activators only just before application
Keep materials sterile and properly labeled
Follow validated spin settings to avoid platelet rupture or poor separation

Using non-cleared kits or inconsistent protocols may reduce efficacy or increase risk, especially in immunocompromised patients.

Snapshot of Evidence 📌

Diabetic Foot Ulcers (DFUs)

A recent meta-analysis found that autologous PRP significantly improved complete healing rates and shortened healing time in diabetic foot ulcers compared to standard dressings.
🔗 Read study – Frontiers in Endocrinology, 2023

A patient-level RCT reported 25% complete wound closure with PRP gel vs. 0% with saline dressing, with faster mean healing times.
🔗 PubMed: PRP in DFUs

Venous and Pressure Ulcers

Studies report favorable healing outcomes when using PRP in venous leg ulcers and advanced-stage pressure injuries.
🔗 Springer – Clinical Drug Investigation, 2023

A meta-analysis showed a 3.4x greater chance of complete healing in pressure ulcers treated with PRP compared to standard dressings.
🔗 SAGE Journals

A smaller clinical series showed a 52% reduction in wound surface area over 6 weeks using PRP-based treatment.
🔗 Frontiers in Bioengineering, 2023

Broad Chronic Wound Review

A comprehensive review of 48 RCTs covering over 2,000 wounds found PRP therapy to be safe and significantly effective in increasing wound closure rates.
🔗 MDPI – Journal of Clinical Medicine, 2022

Summary: The Role of PRP in Difficult Wound Care

The connection between PRP and wound healing lies in its ability to deliver autologous signals that stimulate repair. For patients with stalled healing despite conventional care, PRP offers a biologic option with:

Modest cost compared to cell-based therapies
Minimal risk when prepared properly
Supportive evidence for tissue repair and revascularization

For orthopedic, sports medicine, and wound care specialists, PRP may be a practical tool to add to select cases — especially when paired with proper wound bed preparation, pressure management, and comorbidity control.

✅ Explore PRP Systems for Wound Care at Accretion Portal

Accretion Portal supplies FDA-cleared PRP kits and centrifuge systems used in wound healing, musculoskeletal medicine, and biologic preparation.
Explore our product range or contact us to confirm system compatibility with your clinical protocols.