Topical autologous platelet-rich plasma applied during tonsillectomy could reduce postoperative pain and improve wound healing compared with control treatment, according to a randomized controlled trial.
In the prospective trial, researchers randomly assigned 200 patients undergoing bilateral tonsillectomy to receive intraoperative platelet-rich plasma (PRP) or a control treatment, with 195 included in the analysis.
The primary endpoint was postoperative pain over the first 10 days, assessed using a visual analog scale (VAS). Patients treated with PRP experienced significantly lower pain scores over days 1 through 10, with an average reduction of approximately 0.8 points on the VAS compared with control. Pain reductions were most pronounced during the first 8 days postoperation, with differences no longer statistically significant by days 9 to 10.
Wound healing outcomes also favored PRP. Healing scores were significantly improved at postoperative days 7, 10, and 14, and complete mucosal healing by day 14 occurred in 78% of the PRP-treated patients compared with 59% of those in the control group.
Postoperative bleeding rates were low and similar between the groups. Secondary hemorrhage occurred in 2% of the patients in the PRP group and 5.2% of those in the control group, with no statistically significant difference and no serious adverse events reported.
No primary hemorrhage occurred in either group, and no infections or PRP-related complications were observed. Treatment completion and postoperative care were comparable between the groups. The use of rescue analgesia was numerically lower in the PRP group, though this was not a primary endpoint.
The researchers noted that PRP may enhance healing through the delivery of growth factors that promote epithelialization and tissue repair.
They concluded that intraoperative PRP may be a useful adjunct to improve early recovery after tonsillectomy, while emphasizing the need for larger, multicenter studies to confirm generalizability.
Limitations included the single-center design, lack of age-stratified analyses, and limited power to detect differences in rare outcomes such as bleeding.
"Overall, our findings bolster the case for using PRP in tonsillectomy and potentially in other ENT surgeries where enhanced healing is desired. Considering the evidence across studies, PRP appears to offer a safe method to improve postoperative quality of life by reducing pain and promoting faster recovery," concluded study authors Sedat Rüzgar, of the Department of Otolaryngology at the Bağcılar Training and Research Hospital in Turkey, and Alper Tabaru, of the Department of Otolaryngology at the University of Health Sciences in Turkey.
The study authors reported no external funding and no competing interests.
