Efficacy of autologous blood-derived therapies in diabetic foot ulcers: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Diabetic foot ulcers (DFUs) are a significant complication of diabetes, leading to high morbidity rate, amputation, and health care costs. Autologous blood-derived products, including autologous whole blood clot (AWBC), platelet-rich plasma, and platelet-rich fibrin, have emerged as promising treatments that leverage the body's own healing mechanisms. OBJECTIVE: To evaluate the efficacy of autologous blood-derived products compared with standard-of-care (SOC) treatment in achieving complete healing of DFUs by 12 weeks. METHODS: A systematic review and meta-analysis of sources published through April 2025 was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, Embase, and the Cochrane Library were searched. Randomized controlled trials (RCTs) reporting complete healing at 12 weeks were included. Data were pooled using a random effects model to calculate odds ratio (OR) with 95% CI. RESULTS: Six RCTs with a total of 629 patients met the inclusion criteria. Autologous blood-derived products significantly improved the odds of complete healing at 12 weeks compared with SOC (pooled OR, 2.24; 95% CI, 1.47-3.41; P = .0045). Among these products, AWBC demonstrated the highest efficacy, and there was minimal indication of publication bias. CONCLUSION: Autologous blood-derived products significantly improve healing outcomes in DFUs compared with SOC, supporting their clinical use. Further research should refine product preparation methods and treatment durations to maximize efficacy.