Platelet-leukocyte rich gel application in the prevention of deep sternal wound problems after cardiac surgery in obese diabetic patients

Vermeer, Harry; Aalders-Bouhuijs, Silvia S. F.; Steinfelder-Visscher, Jacoline; Heide, Stefan M. van der; Morshuis, Wim J.

doi:10.21037/jtd.2019.04.42

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…PRP was first used to treat thrombocytopenia [ 26 ]. However, due to its regenerative properties, its use has been extended to multiple medical and surgical fields, including skin rejuvenation and hair regrowth [ 27 , 28 ], cardiac surgery [ 29 ], lung dysfunction [ 30 ], neural repair [ 31 ], and orthopedics [ 14 ]. For the latter, several meta-analysis studies have reported PRP as a safe and effective treatment to address tendon injuries [ 32 ], osteoarthritis [ 33 ], and meniscal lesions [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Platelet-Rich Plasma Gel Matrix (PRP-GM): Description of a New Technique

et al. 2022

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Several musculoskeletal conditions are triggered by inflammatory processes that occur along with imbalances between anabolic and catabolic events. Platelet-rich plasma (PRP) is an autologous product derived from peripheral blood with inherent immunomodulatory and anabolic properties. The clinical efficacy of PRP has been evaluated in several musculoskeletal conditions, including osteoarthritis, tendinopathy, and osteonecrosis. When used in combination with hyaluronic acid (HA), a common treatment alternative, the regenerative properties of PRP are significantly enhanced and may provide additional benefits in terms of clinical outcomes. Recently, a new PRP-derived product has been reported in the literature and is being referred to as “plasma gel”. Plasma gels are obtained by polymerizing plasmatic proteins, which form solid thermal aggregates cross-linked with fibrin networks. Plasma gels are considered to be a rich source of growth factors and provide chemotactic, migratory, and proliferative properties. Additionally, clot formation and the associated fibrinolytic reactions play an additional role in tissue repair. There are only a few scientific articles focusing on plasma gels. Historically, they have been utilized in the fields of aesthetics and dentistry. Given that the combination of three products (PRP, HA, and plasma gel) could enhance tissue repair and wound healing, in this technical note, we propose a novel regenerative approach, named “PRP–HA cellular gel matrix” (PRP-GM), in which leukocyte-rich PRP (LR-PRP) is mixed with a plasma gel (obtained by heating the plasma up) and HA in one syringe using a three-way stopcock. The final product contains a fibrin–albumin network entangled with HA’s polymers, in which the cells and biomolecules derived from PRP are attached and released gradually as fibrinolytic reactions and hyaluronic acid degradation occur. The presence of leukocytes, especially monocytes and macrophages, promotes tissue regeneration, as type 2 macrophages (M2) possess an anti-inflammatory feature. In addition, HA promotes the viscosuplementation of the joint and induces an anti-inflammatory response, resulting in pain relief. This unique combination of biological molecules may contribute to the optimization of regenerative protocols suitable for the treatment of degenerative musculoskeletal diseases.

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Section: Discussionmentioning

confidence: 99%

Platelet-Rich Plasma Gel Matrix (PRP-GM): Description of a New Technique

et al. 2022

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“…The effect of PRP treatment in accelerating bone formation was studied in a sheep model and was found to have an enhanced new bone formation without any adverse effects 91 . In another study, the PRP gel was applied on the sternal halves of diabetic patients 92 . They observed a significant decrease in infection in PRP gel treated patients with respect to the control where the gel is not applied.…”

Section: Progress In Enhancing Sternal Healing Controlling Bleedingmentioning

confidence: 99%

Recent developments in controlling sternal wound infection after cardiac surgery and measures to enhance sternal healing

Pradeep

Rangasamy

Varma

2020

Medicinal Research Reviews

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One of the major risks of cardiac surgery is the occurrence of infection at the sternal wound site. Sternal wound infections are primarily classified into superficial infection and deep sternal wound infection or mediastinitis. A patient is diagnosed with mediastinitis if microorganisms are present in their mediastinal tissue/fluid or with the observation of sternal wound infection during operation and with characteristic symptoms including chest pain, fever, and purulent drainage from the mediastinum. It is usually caused by Staphylococcal organisms in 75.8% of cases and the rest is caused by gram‐negative bacteria. Currently, in cardiac surgery, hemostasis is achieved using electrocautery and bone wax, and the sternum is closed using wire cerclage. Several studies show that bone wax can act as a nidus for initiation of infection and the oozing blood and hematoma at the site can promote the growth of infectious organisms. Many research groups have developed different types of biomaterials and reported on the prevention of infection and healing of the sternum. These materials are reported to have both positive and negative effects. In this review, we highlight the current clinical practices undertaken to prevent infection and bleeding as well as research progress in this field and their outcomes in controlling bleeding, infection, and enhancing sternal healing.

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Post‐ICU Care and Other Complications

2020

Manual of Perioperative Care in Adult Cardiac Surgery

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Platelet-leukocyte rich gel application in the prevention of deep sternal wound problems after cardiac surgery in obese diabetic patients

Cited by 4 publications

References 17 publications

Platelet-Rich Plasma Gel Matrix (PRP-GM): Description of a New Technique

Platelet-Rich Plasma Gel Matrix (PRP-GM): Description of a New Technique

Recent developments in controlling sternal wound infection after cardiac surgery and measures to enhance sternal healing

Post‐ICU Care and Other Complications

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