Is Placentrex (human placental extract) more effective than Regen-D (platelet-derived growth factor) and collagen gel for wound care?

Placentrex Gel vs. Regen-D and Collagen Gel for Wound Care

Placentrex (human placental extract) is not proven superior to Regen-D (platelet-derived growth factor) or collagen gel for wound healing, and current guidelines do not recommend any of these products as first-line treatments for diabetic foot ulcers or chronic wounds. 1

Evidence Assessment

Placental-derived Products (Placentrex)

• The IWGDF conditionally recommends placental-derived products as adjunct therapy only when standard care has failed 1
• Evidence quality supporting placental products is generally low to moderate 2
• Cost considerations are significant: $2000-3000 per healed ulcer for some placental products 1
• Contains growth factors, collagen-rich extracellular matrix, antimicrobial proteins, and angiogenic factors 2

Platelet-derived Growth Factor (Regen-D)

• IWGDF explicitly suggests not using growth factor therapy as adjunct therapy for wound healing in diabetic foot ulcers 1
• Only one study at low risk of bias showed no difference in healing between PDGF and control groups 1
• Earlier large trials showing positive results had moderate to high risk of bias 1
• None of the PDGF studies reported on sustained healing, amputation prevention, resource utilization, or mortality 1

Collagen Products

• Studies of collagen/oxidized regenerated cellulose dressings failed to show effect on healing 1
• The largest study of collagen products showed no improvement in healing 1
• Current guidelines do not recommend collagen products over standard care 1

Clinical Decision Algorithm

1. First-line approach: Implement standard wound care practices

   • Appropriate wound cleansing
   • Debridement of necrotic tissue
   • Appropriate dressings
   • Management of underlying conditions
   • Offloading (for diabetic foot ulcers)

2. For non-healing wounds (after 4 weeks of standard care with <50% reduction):

   • Consider advanced wound therapies based on wound characteristics and available resources
   • If resources permit and standard care has failed, placental-derived products may be considered as an adjunctive therapy 1, 2
   • Do not use growth factor therapy (including Regen-D) or collagen products as routine adjunctive therapy 1

Important Considerations

• Cost-effectiveness: All three products are expensive with limited evidence supporting their use
• Quality of evidence: Most studies supporting these products have methodological flaws or high risk of bias 1
• Pitfalls to avoid:
  • Relying on these products before optimizing standard wound care
  • Using these products for infected or ischemic wounds without addressing underlying issues
  • Expecting significant results without proper wound bed preparation

Conclusion

Current evidence does not support that Placentrex is superior to Regen-D or collagen gel for wound healing. The IWGDF guidelines explicitly recommend against growth factor therapy (including Regen-D) and do not recommend collagen products, while only conditionally suggesting placental-derived products when standard care has failed 1. Standard wound care practices remain the cornerstone of treatment for diabetic foot ulcers and chronic wounds.