Platelet-Rich Plasma: A Review of Biology and Applications in Plastic Surgery

Abstract

Learning Objectives: After studying this article, the reader should be able to: 1. Define the role of platelets in hemostasis and wound healing. 2. Describe the technologies for platelet concentration and application. 3. Characterize the platelet concentration and growth factor components of platelet-rich plasma. 4. List the potential applications of platelet-rich plasma in plastic surgery and how it may be applied intraoperatively. 5. Discuss the limitations of the use of platelet-rich plasma and its potential complications.Summary: Healing of hard and soft tissue is mediated by a complex array of intracellular and extracellular events that are regulated by signaling proteins, a process that is, at present, incompletely understood. What is certain, however, is that platelets play a prominent if not deciding role. Controlled animal studies of soft and hard tissues have suggested that the application of autogenous platelet-rich plasma can enhance wound healing. The clinical use of platelet-rich plasma for a wide variety of applications has been reported; however, many reports are anecdotal and few include controls to definitively determine the role of platelet-rich plasma. The authors describe platelet biology and its role in wound healing; the preparation, characterization, and use of platelet-rich plasma; and those applications in plastic surgery for which it may be useful.Healing of hard and soft tissue is mediated by a complex array of intracellular and extracellular events that are regulated by signaling proteins, a process that is, at present, incompletely understood.1-5 What is certain, however, is that platelets play a prominent if not deciding role.3,6 Platelet activation in response to tissue damage and vascular exposure results in the formation of a platelet plug and blood clot to provide hemostasis and the secretion of biologically active proteins. These proteins, in turn, set the stage for tissue healing, which includes cellular chemotaxis, proliferation, and differentiation; removal of tissue debris; angiogenesis; and the laying down of extracellular matrix and regeneration of the appropriate type of tissue. 2-4,6 In vitro, there is a dose-response relationship between platelet concentration and the proliferation of human adult mesenchymal stem cells, the proliferation of fibroblasts, and the production of type I collagen.7,8 This suggests that the application of autogenous platelet-rich plasma can enhance wound healing, as has been demonstrated in controlled animal studies for both soft and hard tissues. 9,10

Is there any association between mycosis fungoides and Th-1, Th-2 cytokines and transforming growth factor-beta 1 gene polymorphisms?

“…The interaction between these bioactive proteins and receptors has a key role in the process of wound healing 7,8 . PRP is used in the treatment of chronic cutaneous and soft tissue ulcerations and especially in periodontal and oral surgery, maxillofacial surgery, orthopedic and traumatic surgery, cosmetic and plastic surgery, spinal surgery, heart by-pass surgery, and in burns [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] . The purpose of our study was to examine the histopathological effects of topical PRP and PPP treatments in wound healing on rats with partial thickness wounds.…”

Effects of platelet rich plasma on fascial healing in rats with fecal peritonitis

“…The reason for the small number of negative outcomes may be the equipment used, the protocol used to activate the platelet gel, specific characteristics of the patient and the lesion, the platelet concentration used, the way of applying-obtaining it and different storage times 13 .…”

Intérêt de l’oxygénothérapie hyperbare dans la prévention et le traitement des ostéonécroses des maxillaires dues aux bisphosphonates

“…Compte tenu de la structure des plaquettes et de leur capacité à interagir avec leur environnement cellulaire, le PRP favorise la cicatrisation. Le fait d'amener directement les plaquettes sur le site permet de créer un environnement local propice à la régénération tissulaire [34]. [29].…”