The Safety and Efficacy of Platelet-Rich Plasma in Enhancing Outcomes Following Circumcision in Children.

Background

The primary objectives of platelet-rich plasma (PRP) therapy are to enhance the wound-healing process, reduce pain, and minimize the loss of productivity due to recovery time. Localized application of PRP, which is enriched with growth factors such as PDGF, TGF-β1, IGF-1, VEGF, and FGF-2, as well as interleukins (IL-1, IL-4, IL-6, IL-10, and IL-13), has been documented to accelerate the healing process by approximately 30-40%. This study aimed to assess the safety and efficacy of platelet-rich plasma (PRP) in enhancing outcomes following circumcision in male children.

Methods

The patients were divided into two groups: one undergoing standard circumcision and the other receiving PRP application during circumcision. Pain scores, edema level, bleeding, local infection, and safety of PRP were evaluated.

Results

This study evaluated 80 male children undergoing circumcision, divided into two groups: Group CS (n = 44) underwent classical circumcision, and Group PRP (n = 36) received PRP application. Median ages were comparable (p = 0.101). Penile edema occurred less frequently in the PRP group (5.6%) compared to the CS group (18.2%) (p = 0.089), with no severe edema observed in the PRP group. Postoperative bleeding was present in 6.8% of the CS group but absent in the PRP group (p = 0.110). Other complications, such as nausea (CS: 6.8%, PRP: 5.6%, p = 0.816), vomiting (CS: 4.5%, PRP: 2.8%, p = 0.679), local infection (CS: 2.3%, PRP: 0%, p = 0.363), wound dehiscence (CS: 2.3%, PRP: 0%, p = 0.363), and skin tunnel formation (CS: 6.8%, PRP: 2.8%, p = 0.409), showed no significant differences. No cases of necrosis, chordee, rotational anomaly, or secondary phimosis were observed. Safety analysis of PRP revealed minor complications during blood draw: hypotension in one patient (2.8%) and local ecchymosis in two patients (5.6%), resolving without intervention. During PRP application, one allergic reaction (2.8%) occurred, presenting as a transient rash that resolved spontaneously. Group PRP consistently reported lower pain scores than Group CS at all time points.

Conclusions

PRP application during circumcision is safe. The findings provide preliminary but important evidence regarding the potential benefits of PRP in pediatric circumcision.