Topical application of autologous blood products during surgical closure following a coronary artery bypass graft☆

Abstract

This retrospective analysis of a consecutive series of patients receiving a coronary artery bypass grafting procedure concluded that application of platelet rich and platelet poor plasma significantly reduced occurrences of chest wound infection, chest drainage, and leg wound drainage. This novel therapy merits further investigation.

Review of concentration yields in commercially available platelet-rich plasma (PRP) systems: a call for PRP standardization

“…While PRP was first used in the 1970s for wound and bone healing in the field of oral and maxillofacial surgery,3 there are now several high-quality systemic reviews, meta-analyses and randomized controlled trails supporting its applications in many fields, including dermatology,4 cardiology,5 plastic surgery,6 orthopedic surgery,7 pain management8 and sports medicine 9 10. As the popularity of this autologous derivative of whole blood grows and it is further studied, the definition of PRP is shifting to be having a minimum platelet concentration of 1 000 000/µL or approximately a fivefold increase in platelets from baseline 11…”

Topical use of autologous fibrin glue in high-risk CABG patients

“…This is especially true for the platelet rich fibrin glue [7]. This theory has been supported by two recent publications showing an enhanced healing response in healthy individuals when PRP was applied to biopsy sites at the inner thigh and oral mucosa [16,17].…”

“…Several recent publications have reported an improved postoperative outcome with regard to chest drainage and wound infections following the topical application of autologous fibrin sealant to the chest incision and vein harvest site during surgical closure [7,11,12]. These studies support the adjunctive use of autologous blood components in cardiothoracic procedures and warrant further investigation into the safety and efficacy of this technique.…”

“…The use of topical hemostatic agents has been advocated for use in cardiothoracic surgery for numerous indications [7][8][9][10]. While a high number of different sealants are commercially available, autologous fibrin glue is used at our institution almost exclusively.…”

Clinical impact and biomaterial evaluation of autologous platelet gel in cardiac surgery

“…A dual syringe technique was used with the platelet concentrate drawn into a 10-mL syringe while the bovine thrombin/CaCl 2 solution was drawn into a 1-mL syringe. The APG was created by mixing the platelet concentrate with the reconstituted thrombin in a ratio of 10 parts concentrate to 1 part thrombin/CaCl 2 The quality and standardization of APG were verified by platelet count, levels of betathromboglobulin and platelet-derived growth factor (PDGF-AB). APG was prepared before surgery for all patients and used for wound care in cases where there was not any significant bleeding.…”