New insights into and novel applications for platelet-rich fibrin therapies

Anitua, Eduardo; Sánchez, Mikel; Nurden, Alan T.; Nurden, Paquita; Orive, Gorka; Andı́a, Isabel

doi:10.1016/j.tibtech.2006.02.010

Cited by 448 publications

(378 citation statements)

References 49 publications

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“…Another advantage of using MSC and PLG is that these two components are autologous, nontoxic, and biodegradable, proportional to the development of new bone formation, as compared with allogeneic matrices, which are nondegradable during the first weeks after implantation [51].…”

Section: Tissue Engineeringmentioning

confidence: 99%

The use of autologous platelet–leukocyte gels to enhance the healing process in surgery, a review

et al. 2007

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Background: The therapeutic use of autologously prepared, platelet-leukocyte-enriched gel (PLG) is a relatively new technology for the stimulation and acceleration of soft tissue and bone healing. The effectiveness of this procedure lies in the delivery of a wide range of platelet growth factors mimicking the physiologic wound healing and reparative tissue processes. Despite an increase in PLG applications, the structures and kinetics of this autogenously derived biologic material have not been observed. Methods: A review of the most recent literature was performed to evaluate the use of PLG in various surgical disciplines. Results: The review showed that the application of PLG has been extended to various surgical disciplines including orthopedics, cardiac surgery, plastic and maxillofacial surgery, and recently also endoscopic surgery. Conclusion: This review demonstrates the usefulness of PLG in a wide range of clinical applications for improvement of healing after surgical procedures.Key words: Growth factors -Leukocytes -Platelet gel -Wound healing Soft tissue wound healing and bone growth involve physiologic cascades in which cellular and hormonal factors play pivotal roles [1,2]. Some of these cascade components can be isolated from autologously drawn whole blood. Point-of-care devices can intraoperatively fractionate the autologous blood into platelet-poor plasma, platelet-leukocyte-rich plasma (P-LRP), and red blood cells [3,4]. The P-LRP fraction, a mixture of concentrated platelets and leukocytes, can be activated by (autologous) thrombin to create a viscous solution known as platelet-leukocyte gel (PLG). This platelet coagulum can be exogenously applied to soft wound tissues, bone, or synthetic bone as a spray or as a solid, clotted, gelatinous mass. The rationale for applying platelet gel is based on the delivery of platelet growth factors to tissues and on the fact that platelet a-granules, found inside the platelets, contain a variety of growth factors [5]. Platelet gel growth factors are peptides that promote cell proliferation, differentiation, chemotaxis, and the migration of various cells involved in both wound healing and bone growth [6,7].Recently, numerous P-LRP devices have become available for therapeutic use to stimulate and accelerate soft tissue and bone healing and to control postoperative wound bleeding. The rationale for applying PLG lies in the mimicking and accelerating of physiologic wound healing and reparative tissue processes.This article provides information on the results of electron microscopic imaging used to evaluate the content of PLG. Furthermore, because the use of PLG is a relatively new per-and/or perioperative biotechnological application, new and additional indications for the use of PLG are defined. New PLG applications are reviewed for different applications including cardiac surgery, general surgery, orthopedics and traumatology, cosmetic surgery, maxillofacial surgery, sports medicine, and endoscopic surgical procedures. Defining platelet-leukocyte-rich...

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Section: Tissue Engineeringmentioning

confidence: 99%

The use of autologous platelet–leukocyte gels to enhance the healing process in surgery, a review

et al. 2007

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“…[8][9][10][11] Such discrepancies probably relate to the lack of standardization of PRP preparation protocols. 12 The protocols and surgical techniques used in preparing and administering PRP differ widely, 13,14 and variations can greatly influence PRP's biological effects. 12 Recent studies showed differences in GFs levels in PRP samples with the same platelet concentration.…”

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confidence: 99%

Influence of the ratio of particulate autogenous bone graft/platelet-rich plasma on bone healing in critical-size defects: A histologic and histometric study in rat calvaria

et al. 2009

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The purpose of this study was to analyze histomorphometrically the influence of the ratio of particulate autogenous bone (AB) graft/platelet-rich plasma (PRP) on bone healing in surgically created critical-size defects (CSD) in rat calvaria. Fifty rats were divided into five groups: Group C (control), Group AB, Group AB/PRP-50, Group AB/PRP-100, and Group AB/PRP-150. A 5-mm diameter critical-size defect was created in the calvarium of each animal. In Group C, the defect was filled by blood clot only. In Group AB, the defect was filled with 0.01 mL of AB graft. In Groups AB/PRP-50, AB/PRP-100, and AB/PRP-150, the defects were filled with 0.01 mL of AB graft combined with 50, 100, and 150 mL of PRP, respectively. All animals were euthanized at 30 days postoperative. Histomorphometry, using image analysis software, and histology analyses were performed. New Bone Area (NBA) and the remaining bone graft particles area (RPA) were calculated as a percentage of the total area of the original defect. Percentage data were transformed into arccosine for analysis. No defect completely regenerated with bone. Group AB/PRP-50 (41.78 AE 13.48%) had a significantly greater NBA than Groups C (19.29 AE 5.11%), AB (27.43 AE 10.90%) or AB/PRP-150 (19.17 AE 8.45%) (p < 0.05). No significant differences were observed between groups AB/PRP-50 and AB/ PRP-100 or among groups AB, AB/PRP-100, and AB/PRP-150 with regard to NBA (p > 0.05). Group AB/PRP-150 (31.59 AE 3.22%) had a significantly greater RPA than Groups AB (19.09 AE 5.21%), AB/PRP-50 (17.33 AE 4.43%), and AB/PRP-100 (19.72 AE 3.62%) (p < 0.001). No significant differences were observed among groups AB, AB/PRP-50, and AB/PRP-100 with regard to RPA (p > 0.05). The ratio AB graft/PRP influences bone healing in surgically created CSD in rat calvaria. ß

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“…Otros utilizan trombina exógena o endógena inmediatamente antes de la administración (Figura 2), para así activar la cascada de degranulación de las plaquetas, la formación del coágulo y la liberación de factores de crecimiento en el sitio de inyección 10 . Otro activador utilizado es el cloruro de calcio, el cual no tendría el riesgo de reacciones de hipersensibilidad de la trombina exógena 1 . La inclusión de leucocitos dentro del PRP también es controversial.…”

Section: Preparación Del Prpunclassified

“…La inclusión de leucocitos dentro del PRP también es controversial. Si bien quienes la favorecen basan su argumento en la posibilidad de disminuir las tasas de infección local, se ha visto que provocaría efectos deletéreos producto de metaloproteinasas las cuales podrían provocar daño tisular importante en la zona de inoculación, razón por la cual no se incluyen de regla en los preparados 1 .…”

Section: Preparación Del Prpunclassified

Uso del plasma rico en plaquetas en cirugía ligamentosa de rodilla

Ximena

et al. 2013

Rev. méd. Chile

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New insights into and novel applications for platelet-rich fibrin therapies

Cited by 448 publications

References 49 publications

The use of autologous platelet–leukocyte gels to enhance the healing process in surgery, a review

The use of autologous platelet–leukocyte gels to enhance the healing process in surgery, a review

Influence of the ratio of particulate autogenous bone graft/platelet-rich plasma on bone healing in critical-size defects: A histologic and histometric study in rat calvaria

Uso del plasma rico en plaquetas en cirugía ligamentosa de rodilla

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