Platelet-rich plasma for post-tonsillectomy pain, haemorrhage, and wound healing: a systematic review and meta-analysis of randomized controlled trials
In brief
Platelet-rich plasma cuts tonsillectomy pain early, but does not speed healing
Across 12 randomized trials involving 723 patients, platelet-rich plasma lowered pain scores by about 1 point on the first and third days after tonsillectomy, but the benefit was short-lived and varied across studies. A possible reduction in bleeding rested on just 12 events and was not robust in sensitivity analysis; complete healing did not differ significantly, leaving clinical benefits uncertain.
- Journal
- European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Q1)
- Published
- 13 October 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Mahmoud A Megahed, Hamzah M Alghzawi, Mohamed Rifai, Atef A Hassan, Osama Mohamed Refaat, Islam M Magdy, et al.
- PMID
- 42867652
- DOI
- 10.1007/s00405-026-10723-w
Why clinicians should know about it
- Picked for Otorhinolaryngology (paper of the day, 16 October 2026): PRP may reduce early post‑tonsillectomy pain
Abstract
PURPOSE: To determine whether intraoperative autologous platelet-rich plasma (PRP) reduces postoperative pain and haemorrhage and enhances wound healing after tonsillectomy, while critically evaluating the limitations that affect clinical translation and future applications. METHODS: Five databases were searched through 3 July 2026 for randomized controlled trials comparing PRP with no PRP, placebo, or an untreated contralateral fossa. Risk of bias was assessed using RoB 2 and certainty using GRADE. Random-effects models with Hartung-Knapp adjustment were used for pain and healing outcomes; sparse haemorrhage outcomes were analysed using Mantel-Haenszel common-effect models with sensitivity analyses. Parallel-group and split-mouth trials were analysed separately. RESULTS: Twelve randomized trials including 723 patients were included, with 11 contributing quantitative data. PRP was associated with reduced pain on postoperative day (POD) 1 (MD -1.21, 95% CI -2.01 to -0.40) and POD 3 (MD -1.12, 95% CI -2.10 to -0.14), although effects were heterogeneous and transient. Primary haemorrhage showed a favourable common-effect estimate (RR 0.23, 95% CI 0.07-0.80), but this was based on only 12 events and was not confirmed by random-effects sensitivity analysis. Complete healing did not significantly differ between groups (RR 1.34, 95% CI 0.59-3.06). CONCLUSION: PRP may provide a modest early analgesic effect after tonsillectomy, but current evidence does not demonstrate a consistent improvement in haemostasis or mucosal healing. Future research should focus on standardized PRP characterization, patient-level comparative trials, and direct evaluation of whether PRP improves tissue regeneration compared with other biomaterial-based approaches.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.