A meta-analysis of efficacy and safety of platelet-rich concentrate in assisting facial fat transplantation
10.3760/cma.j.cn114453-20230506-00097
- VernacularTitle:富血小板浓缩物辅助面部脂肪移植效果与安全性的meta分析
- Author:
Xuhui DENG
1
;
Ting YANG
;
Qianli YANG
Author Information
1. 长沙爱思特医疗美容医院美容外科，长沙 410000
- Keywords:
Meta-analysis;
Fat transplantation;
Platelet-rich concentrate;
Facial rejuvenation
- From:
Chinese Journal of Plastic Surgery
2023;39(10):1062-1073
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically evaluate the clinical efficacy and safety of autologous platelet-rich concentrate in facial fat transplantation.Methods:By combining subject headings with free words, the randomized controlled trials of platelet-rich concentrate combined with autologous fat grafting (AFG) on improving facial morphology were searched in domestic and foreign databases (PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Database, VIP Database) published in Chinese and English from database establishment to April 2023. According to inclusion and exclusion criteria, NoteExpress was used to screen relevant literatures, quality evaluation and data extraction were carried out for the final included literatures, and statistical analysis of the data was carried out using Review Manager 5.4 and Stata 15.0. For the count data, the risk ratio ( RR) was used as the statistical effect index, and the Mantel-Haenszel(M-H) hierarchical analysis method was used to calculate the combined results. For the measurement data, mean difference ( MD) was used as the statistical effect indicator, and the combined results were calculated by the inverse-variance(I-V) method. The heterogeneity among the studies was comprehensively tested by Q test combined with I2 statistic. If there was high heterogeneity among the studies, the random effect model was used for statistical analysis. Otherwise, the fixed effect model was used for statistical. Results:A total of 1 238 literatures were retrieved, and 19 randomized controlled trials involving 1 168 patients were eventually included after screening. The papers were all published within the last 10 years, mainly by Chinese authors. In the experimental group, the intervention measures of four studies were platelet-rich fibrin combined with AFG, two studies were concentrated growth factor combined with AFG, and the other thirteen studies were platelet-rich plasma combined with AFG. The results showed that: compared with fat transplantation alone, the addition of platelet-rich concentrate could improve the long-term fat retention rate ( MD=18.20%, 95% CI 14.03%-22.37%, P<0.001) and increase the operative response rate ( RR=1.22, 95% CI 1.15-1.29, P<0.001), shorten the postoperative recovery time ( MD=-4.18 d, 95% CI -7.01 d to -1.34 d, P=0.004), and reduce the incidence of secondary surgery ( RR=0.24, 95% CI 0.15-0.40, P<0.001), furthermore, patient satisfaction was improved ( RR=1.25, 95% CI 1.17-1.33, P<0.001). In addition, the incidence of complications during treatment was reduced ( RR=0.35, 95% CI 0.24-0.51, P<0.001). Conclusion:The efficacy and safety of platelet-rich concentrate assisted fat transplantation on face are worthy of recognition, and more large-scale and multi-center studies are needed for further clinical promotion.
