Document Type

Article

Publication Date

4-14-2026

Abstract

Background: Postoperative wound complications persist as a significant challenge within adult cardiac surgery. Deep and superficial sternal wound infections, along with complications at saphenous vein harvest sites, are linked to increased morbidity, extended hospital stays, and substantial healthcare expenses. Topical platelet-rich plasma (PRP), commonly known as platelet gel, has been suggested as a biologically active adjunct that may facilitate tissue repair and mitigate postoperative complications. While PRP has garnered attention in surgical practice, the overall scope and consistency of the supporting evidence in cardiac surgery remain ambiguous.

Objective: The purpose of this scoping review is to map and describe the existing literature concerning the application of topical PRP in adult cardiac surgery. Special emphasis was placed on reported effects related to sternal wound healing, outcomes at the saphenous vein harvest site, postoperative bleeding, and potential economic implications.

Methods: A scoping review was conducted in accordance with the PRISMA-ScR framework. Literature searches were executed within PubMed, the Cochrane Central Register of Controlled Trials, The Journal of Thoracic and Cardiovascular Surgery, The Journal of Extracorporeal Technology, Wiley Online Library, and the Lipscomb University Beaman Library. Studies published from 2000 through 2025 were included. Eligible articles encompassed randomized trials, quasiexperimental studies, and observational analytic designs involving adult patients undergoing cardiac surgery who were treated with topical PRP. Data extraction was performed utilizing a standardized charting form and was comprehensively summarized descriptively. In alignment with established scoping review methodology, a formal risk-of-bias assessment was not undertaken.

Results: The existing literature encompasses randomized trials, observational cohort studies, and technical reports detailing intraoperative PRP application. Numerous studies have indicated lower rates of sternal wound infection following PRP utilization; however, the extent and consistency of these findings varied across different study designs. Evidence concerning postoperative bleeding and outcomes at saphenous vein harvest sites was less consistent. Some investigations proposed that patients with higher baseline risks—particularly those with advanced age, diabetes, or obesity—may benefit more significantly from platelet gel application. A limited number of studies also highlighted potential economic benefits, primarily through 2 reductions in wound complications and hospital length of stay. Overall, substantial heterogeneity in study design, PRP preparation protocols, application techniques, and outcome definitions has limited the comparability of results across studies.

Conclusions: Current evidence indicates that the application of topical PRP in adult cardiac surgery may be linked to enhanced wound-related outcomes, especially in patients at elevated risk. However, variability in research methodologies and inconsistent results hinder definitive conclusions concerning its efficacy. The development of standardized protocols and well-designed comparative studies is essential to elucidate the clinical utility of PRP within cardiac surgical practice.

Keywords: Platelet-rich plasma; Platelet gel; Cardiac surgery; Sternal wound infection; Saphenous vein harvest; Wound healing; Postoperative bleeding; Infection prevention.

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