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Platelet rich plasma

What is it platelet-Rich plasma?

Platelet rich plasma (PRP) is a higher concentration of autologous. platelets suspended in a small amount of plasma after centrifugation and used for injection into a wound or a particular skin condition. Platelet rich plasma is also called autologous platelet gel, plasma rich in growth factors (PRGF) and platelet concentrate (PC).

Blood normally consists of approximately 93% of red blood cells (RBC), 1% of white blood cells (WBC) and 6% of platelets, suspended in plasma. Normal platelet count the range is 150,000 to 350,000 per µL of blood. In platelet-rich plasma, the red blood cell count drops to 5, while the platelet count increases to 94% (three to eight times higher than normal).

PRP is "autologous," which means that it comes from the patient's own body.

How rich is it in platelets? plasma Picked up?

Blood is drawn from a patient's arm with a syringe.

  • The tubes containing drawn blood are placed in a centrifuge and centrifuged using a carefully determined protocol.
  • The speed and duration of centrifugation are very important to ensure that platelets are not damaged.
  • Centrifugation separates the red and white blood cells and platelets and concentrates them to various levels in the tubes.
  • Blood plasma that is rich in platelets is drawn from the appropriate level to therapeutic use.
  • An activating agent (eg, calcium chloride) is added to activate platelets and release their contents before use.
  • Predictable and efficient compact systems for developing PRP are commercially available (eg, RegenLab, Switzerland) and can be used in office and hospital environments.

Background information on platelet rich plasma

Platelets are probably best known as components of the blood clotting system. When the injury interrupts a blood vessel and causes bleeding, platelets become activated and help form a clot that prevents blood flow.

In addition, each platelet is also a biochemical repository for regulatory, signaling, and growth factors. molecules involved in the recovery and healing of tissue in response to injury.

As an autologous preparation, PRP is safer to use than allogeneic or homologous preparations and is free from concerns about communicable diseases such as HIV, hepatitis, West Nile feverand Creutzfeldt-Jakob disease.

PRP does not require special considerations regarding antibody formation, effectively preventing the risk of graft vs. host disease and leading to better acceptance by patients.

Role of platelet-rich plasma in wound healing.

Effects of PRP Soft fabric healing through growth factors released after platelets degranulation. These growth factors initiate and improve physiological processes that contribute to tissue recovery and healing after injury

Growth factor molecules associated with platelets include:

  • Platelet derived growth factor (PDGF-AA, PDGF-BB, PDGF-AB)
  • Transforming growth factor beta (TGF-b1, GFR-b2)
  • Vascular endothelial growth factor (VEGF)
  • Epidermal growth factor (EGF)
  • Pro and antiinflammatory cytokines (interleukin [IL] -4), IL-8, IL-13, IL-17, tumor necrosis alpha factor and alpha interferon)
  • Fibroblasts growth factor-2 (FGF-2)
  • Insulin-as growth factor (IGF)
  • Fibrin, fibronectin, vitronectin, thrombin.

These growth factors aid healing by:

  • Attract undifferentiated stem cells to the newly formed matrix and trigger cell division
  • Suppressing cytokine liberation and limitation inflammation
  • Attracting macrophages to improve tissue healing and regeneration
  • Promoting new capillary growth (formation of new blood vessels) and acceleration of epithelialization.

Indications for rich platelets plasma injections

There is accumulating evidence that PRP can aid wound healing.

  • Venous and arterial leg ulcers
  • Diabetic foot ulcers
  • Pressure ulcers (pressure ulcers).

  • Skin graft donor sites

  • First and second degree thermal burns.
  • Superficial injuries, cuts, abrasions and surgical wounds.
  • Hair loss: PRP has been shown to revitalize dormant hair follicles and stimulate new hair growth in the male pattern alopecia
  • Send-traumatic scars - PRP combined with centrifuged and fractional fatty tissue To be Rejuvenation improves the cosmetic appearance of scars.
  • Facial rejuvenation
  • Ocular indications may include dry eye and eyelid injection
  • Urologic indications can include urinary incontinence and sexual well-being.
  • Sports medicine and dentistry

PRP injections can treat wrinkles, photodamage and discoloration, and is often used in conjunction with other treatments such as face lift dermal implants and reconstructive procedures.

Security, complications and contraindications with platelet rich plasma

PRP is immunologically neutral and does not represent a risk of allergy, hypersensitivity or foreign body reactions.

Sterile technique should be used at every stage of PRP preparation and application. Sterile technique is especially important if a patient has an underlying medical condition that predisposes to infection.

PRP can be injected intralesionally or perilesional or mixed with autologous thrombin in a ratio of 9: 1, forming a platelet gel and used topically.

When administered by intradermal injection, a brief period of swelling may be experienced at wound sites. Nerve trauma It is another potential complication.

The following medical conditions are a contraindication for PRP use:

  • Critical thrombocytopenia (low platelet count)
  • Hypofibrinogenesis
  • Hemodynamic instability (collapse)
  • Septicemia (infection)
  • Acute and chronic infections
  • Chronic liver disease
  • Anti-coagulation therapy (warfarin, dabigatran, heparin).

What is the evidence to support rich platelets? plasma in wound healing?

The available data are mainly based on case series. These studies have shown:

  • Healing posttraumatic and vascular wounds, diabetic and chronic ulcers with a combination of PRP and autologous fat supported by a three-dimensional matrix of hyaluronic acid.
  • Cosmetic enhancement of scars with fat grafts mixed with PRP, followed by skin rejuvenation with a non-ablative laser
  • Healing of open and chronic wounds of the heel and ankle with a combination of PRP and hyaluronic acid.
  • Healing of dehiscent infected sternal wounds with a local application of PRP.

Case studies conducted in various countries have also shown that patients who may have moderate wrinkles due to exposure to sunlight and / or simply due to age can benefit from PRP treatment.

  • Results show that when PRP is applied by shallow or deep skin injection, skin texture, tone, and firmness can improve within 3 weeks with continued improvement over the next several months.
  • Areas commonly treated with PRP for rejuvenation include the cheeks, around the eyes, jaw, back of hands, neck, knees, elbows, upper arms, and post-pregnancy stretch marks.