Platelet-Rich Preparations to Improve Healing. Part I: Workable Options for Every Size Practice

Abstract

Numerous studies have demonstrated that platelet-rich preparations applied to surgical sites, injuries, or wounds are a safe and effective way to promote soft tissue healing and bone growth. Various protocols have been developed for preparing platelet-rich preparations, with subtle but important differences between them. Unfortunately, only a minority of clinicians use platelet-rich preparations, such as platelet-rich plasma and platelet-rich fibrin, in their practice, possibly due to confusion about the different methods and their advantages and disadvantages. Therefore, the different types of preparations are described to help guide the selection of the best method for any size practice. Classic methods generally require large volumes of blood and can be expensive, complicated, and time-intensive. Simpler protocols have been developed recently, which require relatively inexpensive equipment and small blood volumes and, thus, may be more applicable for small clinical practices. Platelet-rich preparations accelerate healing at earlier time points to reduce discomfort and the potential for adverse outcomes, including infection, poor wound closure, and delays in forming strong bone for subsequent procedures (such as implants). However, platelet-rich preparations may also improve long-term outcomes in patients expected to have impaired healing, such as with lifestyle choices (eg, smoking), medications (eg, steroids), diseases (eg, diabetes, osteoporosis, atherosclerosis), and aging, by supplementing the deficient wound environment to restore proper healing. Therefore, both large and small clinical practices would benefit from utilizing platelet-rich preparations to enhance healing in their patients.

Case series of patients with chronic foot ulcers treated with autologous platelet‐rich plasma

“…The main limitation, in our opinion, is that only a limited number of clinicians are currently able to use PRP treatment in their practice because of facility limitations and lack of uniform protocol. 35 In addition, evidence on PRP's effectiveness is not yet fully established. Even though there have been several randomized control trials showing the effectiveness of the treatment, 25,[36][37][38][39][40][41][42] a recent systematic review has concluded that there is still no adequate evidence to suggest the value of applying the treatment to chronic wounds.…”

Evaluation of L‐PRF combined with deproteinized bovine bone mineral for early implant placement after maxillary sinus augmentation: A randomized clinical trial

“…To overcome this concern, several studies have investigated the addition of growth factors to grafting material aiming at enhance bone neoformation and accelerates graft maturation. 1,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Leukocyte and platelet-rich fibrin (L-PRF), first described by Dohan and colleagues 33 is an autogenous biomaterial containing several growth factors. 1,18,19,25 L-PRF, a second-generation of platelet concentrates, is basically made of concentrated autologous platelets as well as leukocytes and cytokines.…”

“…The L-PRF membranes can either be cut into small pieces and mixed with DBBM or autogenous bone, or be used as a membrane 18 It is a safe, and cost-effective technique to improve repair following surgery. 24 Due to its dense fibrin fiber network with strong mechanical characteristics, 8 it can act as a scaffold for a number of cell types and provide support for mesenchymal stem cells. 38 As growth factors play an important role in tissue regeneration, the present study aimed to investigate the effects of L-PRF to accelerate bone formation after maxillary sinus augmentation combined with DBBM as the graft material, and the outcomes of early placement of dental implants after sinus augmentation.…”

Effects of L‐PRF and A‐PRF+ on periodontal fibroblasts in in vitro wound healing experiments

“…It is reported that interaction between these cells and the fibrin matrix stimulates a slow release of growth factors that may result in a better wound healing in the early phase of this process. 16,17 The first delivered procedure for the PRF preparation that includes a centrifugation step at 708 g of relative centrifugation force-max × 12 min, is called L-PRF. 10,12,18 This protocol was developed to activate the ex vivo coagulation process.…”