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Studies on split-thickness skin grafts
The 2026 meta-analysis included 7 randomized and 3 observational studies. Certainty of evidence was nevertheless rated low to very low.
Scientific article for healthcare professionals
PRP in plastic and reconstructive surgery: current evidence and potential applications
Platelet-rich plasma (PRP) is being investigated in plastic and reconstructive surgery for rhinoplasty, cartilage grafts, skin grafts, wound healing, scars and postoperative recovery. The evidence is not uniform: some questions have controlled clinical data, while others remain clearly experimental.
Important for interpretation: PRP is not a standardized preparation across studies. Tubes, anticoagulants, centrifugation, cellular composition, activation, final volume and application may differ substantially. Results from one system therefore cannot automatically be transferred to another PRP protocol.
What is actually being studied?
The biological rationale is plausible: platelets contain mediators involved in coagulation, cell signalling and tissue repair. Biological plausibility, however, is not proof of clinical benefit. Controlled human studies must show whether relevant outcomes such as wound closure, graft take, scar quality or postoperative symptoms actually improve.
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Patients in the current PRP-cartilage series
The 2026 semi-dried PRP-stabilized diced cartilage technique is a feasibility series without a control group.
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PRP is not PRF
PRP and PRF data must not be conflated. Preparation, fibrin architecture and biological properties differ.
Interactive evidence matrix
The matrix separates clinical signals from low or inconsistent evidence and early experimental concepts. It is not a ranking of treatment options.
Rhinoplasty / nasal healing
low / heterogeneousControlled studies report possible benefits for selected early healing parameters such as crusting. Results for pain, bleeding, synechiae and overall postoperative recovery are not consistent.
Not supported: a general claim that PRP improves rhinoplasty outcomes.
Diced cartilage + PRP
experimentalA 2026 technique was described in two primary rhinoplasties and one revision rhinoplasty. At six months, no clinically visible migration, infection or contour irregularity was reported.
Only 3 patients; no control group, objective volume measurement or histological validation.
Split-thickness skin grafts
clinical signalA 2026 meta-analysis found higher mean graft take and fewer hematomas with adjunctive PRP. Findings for graft loss were not stable in sensitivity analyses.
GRADE: low to very low certainty.
Surgical and burn scars
inconsistentSome studies report better scar scores. Pooled analyses do not show a consistently superior effect across relevant time points and scar types.
Patient-reported improvement at 6 months was reported, but heterogeneity was high.
Postoperative swelling / ecchymosis
very small studiesSplit-face and pilot studies provide isolated signals for less edema or bruising, but sample sizes are too small for robust general conclusions.
Overall postoperative recovery
no uniform endpointThe term combines very different outcomes. An improvement in crusting or hematoma does not equal faster overall recovery.
Rhinoplasty: clinical signals, but no general proof of efficacy
Controlled studies and systematic analyses are now available in nasal surgery, but they combine different operations, PRP preparations and endpoints. Some studies report less crusting or favorable early mucosal findings, while others show no significant difference for several postoperative outcomes.
The 2024 randomized study with 40 patients found differences in dryness and crusting, but this does not establish a global improvement in rhinoplasty outcome. Current evidence supports cautious wording: PRP is being investigated for selected aspects of early nasal healing and clinical signals exist; reliable improvement of aesthetic, functional or overall recovery outcomes has not been established.
Cartilage grafts: an interesting technique with very early evidence
Autologous cartilage grafting is an established surgical tool in rhinoplasty. In diced-cartilage techniques, cartilage is cut into small fragments for contouring or augmentation, and different carrier or stabilization methods are being investigated.
In August 2026, a small technical series described liquid PRP combined with diced cartilage and processed under controlled warm air to create a moldable graft. The technique was used in three patients. At one and six months, the authors reported maintained contour without clinically visible migration, infection or relevant surface irregularity.
Critical point: This is not evidence of improved cartilage integration or reduced resorption. There was no control group, no objective volume measurement, no histology and no long-term follow-up. PRP was prepared with the Silfradent MEDIFUGE CGF system. The findings therefore must not be transferred to Vi PRP-PRO, other PRP tubes or other centrifugation protocols.
A separate 2026 comparison of diced cartilage with fibrin glue, PRP or warm blood likewise did not establish a general superiority of PRP. PRP stabilization of cartilage grafts should therefore still be regarded as a research approach.
Do not mix PRP and PRF evidence: Additional literature exists for platelet-rich fibrin (PRF) with diced cartilage. PRF is not PRP; it has a fibrin matrix and is prepared differently. Positive PRF findings are therefore not proof of PRP efficacy.
Wound healing and split-thickness skin grafts
The clinical evidence is comparatively broader for split-thickness skin grafts. A 2026 systematic review and meta-analysis included ten comparative studies, seven of them randomized controlled trials. Pooled data showed higher graft take and fewer hematomas with adjunctive PRP.
The authors nevertheless rated the certainty of evidence as low to very low. Reasons included heterogeneity in wound causes, PRP protocols, study design and assessment of graft take. For graft loss, the effect was no longer statistically stable in a sensitivity analysis.
This illustrates why a statistically positive pooled result should not be equated with established clinical efficacy.
Scars: individual positive findings, but an inconclusive overall picture
A meta-analysis of 11 randomized trials with 539 participants found no statistically significant advantage in observer-based scar scores at three months. At six months, however, a significant patient-reported PSAS difference favored PRP.
Because scar type, location, PRP preparation, application and follow-up varied considerably and heterogeneity was high, it remains inappropriate to claim that PRP generally prevents or visibly reduces postoperative scars.
Postoperative swelling and recovery
Small studies in facial plastic surgery have examined whether platelet concentrates affect swelling or bruising. Some report trends favoring the treated side, but the samples are too small and the methods too heterogeneous for a reliable general statement.
The term ‘postoperative recovery’ should also be used carefully. Studies actually measure concrete endpoints such as epithelialization, pain, crusting, edema, hematoma, scar scores, graft take or patient satisfaction. A benefit in one parameter does not prove faster overall recovery.
Why PRP studies cannot be compared 1:1
Select a factor. The graphic shows why even a single technical variable can limit transferability of a study result to another system.
Anticoagulant
Type and amount of anticoagulant can influence activation, calcium balance and subsequent processing. Studies should report this parameter transparently.
The more key protocol parameters differ between two studies, the more cautiously their results should be transferred.
What can currently be said with reasonable confidence?
Clinically interesting
Clinical signals exist for split-thickness skin grafts and selected parameters of nasal healing, justifying further controlled research.
Still unresolved
For scars, swelling and broadly defined postoperative recovery, results are not sufficiently consistent.
Early research
PRP as a biological scaffold for diced cartilage is technically interesting, but a clinically established additional benefit has not been demonstrated.
Conclusion
PRP in plastic and reconstructive surgery is not one uniformly validated procedure; it is a research field with markedly different levels of evidence by indication. Clinical signals exist for skin grafts and selected aspects of nasal healing. Scar evidence remains inconsistent, while PRP-stabilized cartilage grafts are still in an early clinical phase.
Assessment of each study requires knowing what PRP was actually produced. Findings should only be transferred to a specific system when preparation, composition, protocol and application are sufficiently comparable.
Selected literature and critical appraisal
- Yenigun A, et al. Semi-Dried PRP-Stabilized Diced Cartilage: A Novel Technique for Stable and Moldable Dorsal Nasal Augmentation in Rhinoplasty. Aesthetic Plastic Surgery. Online 03.08.2026. PubMed. Feasibility series, n=3, no control group, 6-month follow-up.
- Rabie AN, et al. The Functional and Aesthetic Results of Fibrin Glue, Platelet-Rich Plasma (PRP), and Warm Blood as a Scaffold for Diced Cartilage in Saddle Nose Deformity. Facial Plastic Surgery. 2026;42(1):113–125. PubMed. Comparative/descriptive data; no evidence of general PRP superiority.
- Possiedi RD, et al. Effectiveness of Platelet-Rich Plasma Combined with Split-Thickness Skin Grafts for Skin Defects: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2026;15(15):6003. PubMed. 10 studies, 7 RCTs; positive signals but GRADE low to very low.
- AlShehri AA, et al. Efficacy and safety of platelet-rich fibrin combined with diced cartilage in rhinoplasty: a systematic review and meta-analysis. PubMed. PRF, not PRP; the evidence cannot be used as proof for PRP.
- Abd Elrahman YO, et al. The Effect of Platelet-Rich Plasma on the Healing of Nasal Mucosa After Surgery of the Nose: A Randomized Clinical Trial. Indian J Otolaryngol Head Neck Surg. 2024;76(4):2973–2980. PubMed. Randomized study, n=40; differences in dryness/crusting do not establish a global rhinoplasty benefit.
- Alharbi Z, Zafar T. The Efficiency of Platelet-Rich Plasma (PRP) in Treating Post-Burn and Surgical Scars: A Meta-Analysis Study. J Clin Med. 2025;14(23):8490. PubMed. 11 RCTs/539 participants; no significant observer-score advantage at 3 months, patient-reported PSAS favored PRP at 6 months; high heterogeneity.
Why not simply say ‘growth factors = better healing’?
Because a biological mechanism does not prove clinical efficacy. Controlled human trials with suitable comparators and patient-relevant endpoints are needed.
Can a positive study be transferred to every PRP tube?
No. Transferability depends on anticoagulant, centrifugation, cellular composition, activation, volume and application. Relevant differences preclude scientific equivalence.
Is PRF the same as PRP?
No. Both are autologous blood preparations, but their processing and structure differ. In particular, positive PRF findings for cartilage grafts must not be presented as PRP evidence.
Medical and advertising-law notice: This article provides scientific information for healthcare professionals and is not a recommendation for a specific treatment, indication or PRP preparation system. Results apply to the procedures used in each study and cannot automatically be transferred to other tubes, centrifuges or protocols. Indication, implementation and selection of medical devices remain the responsibility of the treating professional in accordance with intended purpose, instructions for use and applicable law.