Impact of the Different Preparation Methods to Obtain Autologous Non-Activated Platelet-Rich Plasma (A-PRP) and Activated Platelet-Rich Plasma (AA-PRP) in Plastic Surgery: Wound Healing and Hair Regrowth Evaluation

Abstract

Autologous therapies using platelet-rich plasma (PRP) need meticulous preparation—currently, no standardised preparation technique exists. Processing Quantitative Standards (PQSs) define manufacturing quantitative variables (such as time, volume and pressure). Processing Qualitative Standards (PQLSs) define the quality of the materials and methods of manufacturing. The aim of this review is to use existing PQSs and PQLs to report the in vivo/in vitro results obtained by using different Kits, that utilise different procedures (classified as Closed-Technique and Opened-Technique) to isolate autologous human activated (AA-PRP) or non-activated PRP (A-PRP). PQSs included the volumes of blood collected as well as the reagents used, the time/gravity of centrifugation, and the duration, temperature and tilt level/speed of centrifugation. PQLSs included the use of Calcium Chloride CaCl2, Kit weight, transparency of Kit components, the maintenance of a closed sterile processing environment and the use of a small centrifuge. Eight CE marked devices for PRP extraction were evaluated: Angel®, Biomed®, Cascade® and Selphyl®, Mag-18®, i-Stem®, MyCells® and Regenlab®. Using a Kit with the PQSs and PQLSs described in this study enables the isolation of A-PRP, thereby meeting consensus quality criteria. As our understanding of Critical Quality Attributes (CQAs) of A-PRP continues to evolve, especially with respect to purity and potency, adjustments to these benchmark PQSs and PQLs will hopefully help isolate A-PRP of desired CQAs with greater reproducibility, quality, and safety. Confirmatory studies will no doubt need to be completed.

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

“…Therefore, it is fair to assume that higher platelet dosages will generate an elevated local concentration of released platelet bioactive factors. However, the correlation between platelet dose, concentration, and the concentration of released platelet bioactive growth factors and agents may not be controlled because there are marked differences in baseline platelet counts between individual patients [ 36 ], and differences exist between PRP preparation methods [ 37 , 38 ]. Likewise, several platelet growth factors involved in tissue repair mechanisms reside in the plasma fraction of PRP (e.g., hepatic growth factor and insulin-like growth factor 1).…”

Multipotent adult progenitor cells grown under xenobiotic-free conditions support vascularization during wound healing

“…8 Graphical summary. Following their transplantation (Tx) in the wound bed, hMAPC cells cultured in xenobiotic-free media positively impact on the early (left) and late (right) healing process by improving both epidermal and dermal healing parameters in a multifactorial fashion these processes are driven by common biomolecular pathways involving common growth factors like VEGF, bFGF, platelet-derived growth factor, and epidermal growth factor (as discussed by Gentile et al [50]).…”

Systematic Review—The Potential Implications of Different Platelet-Rich Plasma (PRP) Concentrations in Regenerative Medicine for Tissue Repair

“…It may be autologous or allogenic and generally, it is possible to distinguish the autologous PRP in two different products—Autologous activated PRP (AA-PRP) and autologous not-activated PRP (A-PRP). These products are considered routine for plastic surgeons and dermatologists with consolidated experience in regenerative medicine [ 1 , 2 ]. Preparation methods are not standardized yet and regenerative mechanisms related to the biomolecular pathway are still the object of study.…”

“…Preparation methods are not standardized yet and regenerative mechanisms related to the biomolecular pathway are still the object of study. The in vivo/in vitro effects of AA-PRP and A-PRP in different field of regenerative medicine to improve the tissue repair have been reported [ 1 , 2 , 3 ]. In particular, in the last fifteen-years, the PRP application has expanded to a wide range of clinical fields, including plastic surgery [ 4 ], trichology [ 5 , 6 , 7 ], dermatology [ 8 , 9 ], maxillofacial surgery [ 10 ], orthopedics [ 11 ] and others.…”