Role of platelet-rich plasma in prevention of port site infection, wound healing and post-operative pain after elective laparoscopic cholecystectomy: A randomised controlled trial.

INTRODUCTION

Laparoscopic cholecystectomy (LC) is the preferred treatment for symptomatic gallstone disease because of its minimally invasive technique and associated benefits. Surgical outcomes are influenced by wound infection, pain and scar quality. Port site infections (PSIs) are a notable issue in laparoscopic procedures, affecting around 1.4% to 6.7% of cases. The use of platelet-rich plasma (PRP) has gained interest for its ability to promote wound healing and antimicrobial property. This study evaluated the role of PRP in improving these outcomes after LC.

PATIENTS AND

METHODS

In this randomised controlled trial, 190 patients were assigned to either the PRP group (n = 95) or control group (n = 95). Freshly prepared PRP was compared with 0.9% normal saline for port site infiltration. Follow-up was conducted on post-operative days 1, 2, 10, 30 and 90. The primary outcome, PSIs, was assessed using the Southampton Scoring System. Secondary outcomes included pain (Numerical Rating Scale [NRS]), wound healing (redness, oedema, ecchymosis, discharge and approximation [REEDA] scale) and scar quality (Vancouver Scar Scale [VSS]).

RESULTS

Mean ages were 35.26 ± 6.40 years (PRP) and 34.84 ± 5.86 years (control) (P = 0.637). PSIs were lower in the PRP group on days 1, 2 and 10. At 1 month, the difference was marginally significant (P = 0.050), and at 3 months, not statistically significant (P = 0.115). Pain scores (NRS) were consistently lower in the PRP group from day 1 to 3 months. Wound healing (REEDA) scores were better in the PRP group at all time points. Scar quality (VSS) at 3 months favored PRP (0.68 ± 0.75) over control (1.51 ± 0.85, P < 0.001).

CONCLUSION

PRP use in LC significantly reduced post-operative pain, improved wound healing and enhanced scar quality, with early reductions in infection rates. PRP shows promise as an adjunct to improve post-operative outcomes after LC.