Regenerative potential of PRP-based scaffolds in chronic wound healing: Mechanisms, advances, and therapeutic insights

Introduction: Chronic wounds such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers often remain trapped in the inflammatory phase due to oxidative stress, protease overactivity, and impaired cellular responses, particularly in diabetic conditions. These wounds require advanced therapeutic strategies beyond conventional care. Regenerative medicine-especially platelet-rich plasma (PRP)-based interventions-has emerged as a promising approach for enhancing wound repair. Methods: This review examines recent developments in PRP-loaded scaffolds, focusing on their biological mechanisms, structural advantages, and clinical applications. It synthesizes findings from key studies that integrate PRP with natural and synthetic biomaterials, often combined with bioactive agents like adipose-derived stem cell exosomes. Results: PRP-containing scaffolds promote wound healing through multiple pathways: enhancing cell proliferation, migration, angiogenesis, and extracellular matrix remodeling; reducing inflammation via M2 macrophage polarization; and facilitating collagen deposition. Their antibacterial properties and controlled release of growth factors such as VEGF and TGF-β1 further support tissue regeneration. Additionally, scaffold composition improves mechanical strength, elasticity, and growth factor bioavailability. Innovations such as GelMA/SFMA hydrogels and COL/PRP-ADSC-exos composites have shown superior outcomes in preclinical models. Conclusions: PRP-based scaffolds offer a multifunctional platform for chronic wound treatment by combining biological activity with structural support. Despite existing challenges such as variability in PRP preparation and limited clinical data, ongoing research and emerging technologies hold strong potential to standardize and enhance these therapies for future clinical translation.