Platelet-rich plasma–based therapeutic systems versus silver sulfadiazine and other conventional therapies for burn wound management: A systematic review and meta-analysis

Background: Platelet-rich plasma (PRP)-based therapies are emerging options for wound repair, but their effectiveness versus silver sulfadiazine and conventional treatments remains uncertain. Methods: PubMed, CENTRAL and Clinicaltrials.gov were searched up to August 31, 2026. Randomized controlled trials and comparative studies of PRP in burn wounds were included. Primary outcomes were healing time and wound healing rate; secondary outcomes included infection and pain. Random-effects meta-analyses used mean differences (MD), standardized mean differences (SMD) or odds ratios (OR), with 95% confidence intervals (CIs), as appropriate. Risk of bias was assessed using RoB 2. Sensitivity analyses used leave-one-out methods. Publication bias was assessed using funnel plots, and certainty of evidence was graded using GRADE. Protocol registered in PROSPERO (CRD420261402578). Results: Fifteen studies were included, 12 in meta-analysis. Comparator-specific analyses showed that PRP-based therapeutic systems significantly reduced healing time compared with silver sulfadiazine (MD −4.20 days, 95% CI −6.14 to −2.26) and saline/placebo (MD −6.22 days, 95% CI −8.57 to −3.86), while results were not significant vs standard wound care/dressing (MD −11.92 days, 95% CI −26.46 to 2.62). Healing rates were improved (OR 5.32, 95% CI 1.71–16.54; P = 0.004). Infection risk was reduced (OR 0.42, 95% CI 0.21–0.84; P = 0.01), while pain reduction showed a statistically significant pooled estimate (SMD -1.12, 95% CI -2.12 to −0.12), though this finding was sensitive to the exclusion of one study and should be interpreted cautiously. Sensitivity analyses confirmed robustness. Funnel plots showed no major publication bias. Conclusions: PRP-based therapies may improve burn wound healing and reduce infection compared with conventional therapies; however, the certainty of evidence is low and larger, well-designed randomized trials are needed to confirm these findings. © 2026