Platelet-rich fibrin, preparation and use in dermatology

Abstract

The goal of these recommendations is to provide a framework to practitioners for implementing useful, evidence-based recommendations for the preparation of platelet-rich fibrin (PRF) and its use in various dermatological indications. The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) assigned the task of preparing these recommendations to its taskforce on platelet-rich plasma. A comprehensive literature search was done in the English language on the PRF across multiple databases. The grade of evidence and strength of recommendation was evaluated on the GRADE framework (Grading of Recommendation, Assessment, Development and Evaluation). A draft of clinical recommendations was developed on the best available evidence which was also scrutinized and critically evaluated by the IADVL Academy of Dermatology. Based on the inputs received, this final consensus statement was prepared. A total of 40 articles (meta-analyses, prospective and retrospective studies, reviews [including chapters in books] and case series) were critically evaluated and the evidence thus gathered was used in the preparation of these recommendations. This expert group recommends use of A-PRF+ protocol, that is (200 g for 8 min) for preparation of solid PRF and C-PRF protocol (700 g for 8 min) for liquid PRF. Swing out bucket model of centrifuge or the horizontal centrifuge is recommended for preparation of both PRF, and liquid PRF. Centrifugation must begin within 90–120 s of drawing of blood. PRF can be used in various indications for skin rejuvenation and nonhealing ulcers as either monotherapy or in combination with other therapies.

Fluid Platelet-Rich Fibrin (PRF) Versus Platelet-Rich Plasma (PRP) in the Treatment of Atrophic Acne Scars: A Comparative Study

“…Recently, PRF has been introduced in the treatment of different diseases to overcome the limitations of PRP. In PRF there is no need of anticoagulant, in addition to the gradual and extended release of growth factors by platelets and leukocytes entrapped within the fibrin matrix in PRF [ 6 , 13 , 14 ].…”

“…The autologous growth factors in PRP and PRF work in synergism with growth factors created by skin needling to improve the collagen remodeling and wound healing. It was found that the growth factors in PRP were released almost totally in first 15 min of injection, requiring more number of sessions at frequent intervals [ 14 , 16 – 18 ].…”

Nanostructure characteristics of three types of platelet-rich fibrin biomaterial: a histological and immunohistochemical study

“…In tendon regeneration, PRF biomaterials are paving the way for new therapeutic strategies that may overcome the limitations of current tendon reconstruction surgical [19][20][21]. PRF biomaterials have been used in various dermatological treatments for various skin disorders [22,23].…”

The Comparison of Platelet‐Rich Plasma Versus Injectable Platelet Rich Fibrin in Facial Skin Rejuvenation

“…Several studies mention the use of anticoagulants and rapid release of growth factors as potential/theoretical drawbacks of PRP [6][7][8]; however, disadvantages of these properties have not been evaluated directly in terms of efcacy or safety. Such potential concerns led to the development of second-generation platelet concentrates where blood was drawn without anticoagulant and centrifuged immediately [9].…”