Application of autologous platelet-rich plasma in herniology: First results of a chronic experiment

Background: Many treatment modalities were tried to treat acne scar & still big challenge for dermatologists. Radiofrequency is a non-ionizing electromagnetic radiation used in medicine for nearly 75 years and the application of autologous Platelet-Rich Plasma has been safely used and documented in many fields of medicine. In dermatology and cosmetics they also are used in treating different conditions. Aim of Study: To evaluate the clinical efficacy of fractional microneedling radiofrequency (FMR) and autologous Platelet-Rich Plasma (PRP) a for treatment of facial acne scars . Patients and Methods: A therapeutic comparative study carried out in Dermatology Sulaimani Private Center for period from 1 st of November, 2014 to end of June, 2015. Forty patients with acne scar were included, we divided these patients into 2 groups; group ‐A (22 patients were treated with FMR alone) & group- B (18 patients treated with both FMR & autologous PRP). Both groups were treated by 3 sessions at 4 weeks interval in between sessions. Clinical assessment of improvement

Synergistic effects of HBO and PRP improve bone regeneration with autologous bone grafting

Expression of Different Glycosaminoglycan Synthetic Phenotypes by Lapine Dermal and Dermal Wound Fibroblasts

Wound infection is still a common problem after open long saphenous vein harvesting. Platelets are important for the healing process. The hypothesis was that spraying of the wounds with platelet-rich plasma might reduce the frequency of harvest site infections. From January to October 2008, 140 patients undergoing first-time coronary artery bypass grafting were randomized into two groups of 70 patients. Both groups had standard surgical leg wound closure and care except topical application of platelet-rich plasma as adjunctive treatment in the active treatment group. End points were wound infection and cosmetic result at 6 weeks. The follow-up was 100% complete. Nine patients (13%) in the treatment group and eight (11%) in the control group experienced harvest site infection (p=0.80). The overall cosmetic result was also similar between the groups (p=0.34), but the top score was borderline and more frequent in the treatment group (p=0.050). Topical application of autologous platelet-rich plasma on vein harvest wounds did not reduce the rate of surgical site infection.

Although chronic pain affects about 1% of the US population, it remains largely resistant to treatment. Despite great variability in pain outcomes, the application of autologous platelet-rich plasma (PRP) has become increasingly popular in attempts to reduce chronic pain. The variability in PRP efficacy raises the question of whether PRP actually has an analgesic capacity, and if so, can that capacity be made consistent and maximized. The best explanation for the variability in PRP analgesic efficacy is the failure during PRP preparation and application to take into account variables that can increase or eliminate its analgesic capabilities. This suggests that if the variables are reduced and controlled, a PRP preparation and application protocol can be developed leading to PRP inducing reliable, complete, and long-term pain relief. The goal of this study was to examine some of the variables that influence platelets and see how they might be controlled to increase the analgesic potential of PRP. Among the variables examined are the physiological status of the patient, methods used to prepare PRP, and methods of PRP application. The goal of modifying these variables is to minimize platelet serotonin content, maximize platelet content of factors that reduce inflammation and pain, while maintaining their bioactivity, maximize platelet capacity to aggregate at injury sites, induce rapid and simultaneous release of their contents, and optimize PRP application protocols. It is concluded that controlling some or many of these variables will lead to PRP that induces reliable, maximum, and long-term relief of chronic pain.

This study evaluated the effects of local application of autologous platelet-rich plasma (PRP) on the tooth extraction site of rats presenting the main risk factors for medication-related osteonecrosis of the jaw (MRONJ). For seven weeks, senile rats were submitted to systemic treatment with vehicle (VEH and VEH-PRP) or 100 μg/Kg of zoledronate (ZOL and ZOL-PRP) every three days. After three weeks, the first lower molar was extracted. VEH-PRP and ZOL-PRP received PRP at the tooth extraction site. Euthanasia was performed at 28 days postoperatively. Clinical, histopathological, histometric and immunohistochemical analyses were carried out in histological sections from the tooth extraction site. ZOL showed lower percentage of newly formed bone tissue (NFBT), higher percentage of non-vital bone tissue (NVBT), as well as higher immunolabeling for TNFα and IL-1β. In addition, ZOL presented lower immunolabeling for PCNA, VEGF, BMP2/4, OCN and TRAP. VEH and ZOL-PRP showed improvement in the tooth extraction site wound healing and comparable percentage of NFBT, VEGF, BMP2/4 and OCN. Local application of autologous PRP proved a viable preventive therapy, which is safe and effective to restore tissue repair capacity of the tooth extraction site and prevent the occurrence of MRONJ following tooth extraction.

Platelet-Rich Plasma Promotes Angiogenesis of Prefabricated Vascularized Bone Graft

This case report presents the successful application of autologous Platelet-rich Plasma (PRP) in treating a 53-year-old male patient with a nonhealing perianal wound that persisted for 71 days following surgery for mixed hemorrhoid and anal fistula, despite conventional therapies, including topical traditional Chinese medicine, antibiotics, and wound care. A series of three PRP treatments, administered on October 25, October 27, and November 1, 2023, accelerated healing, resulting in complete closure of the 1.6 cm wound within 14 days. This was accompanied by reduced pain and no recurrence at follow-up, demonstrating PRP's effectiveness in promoting tissue regeneration, controlling infection, and relieving pain in a refractory post-surgical wound.

Evaluate the effect of topical application of autologous platelet-rich plasma (PRP) in primary repair of complete cleft palate and then compare the result with another group of patients using the same surgical technique, without application of PRP with regard to the incidence of oronasal fistula, velopharyngeal closure, and grade of nasality. Case control study. This study was carried on 44 children with complete cleft palate with age range from 12 to 23 months. The children were divided into two age- and gender-matched groups: All children were subjected to the same technique of V-Y pushback repair of the complete cleft palate. In group A (22 children), the PRP prepared from the patient was topically applied between the nasal and oral mucosa layer during palatoplasty, whereas in group B (22 children) the PRP was not applied. All cases were recovered smoothly without problems. In group A, no oronasal fistula was reported, whereas in group B three patients (13.6%) had postoperative fistulae and two patients (9.1%) needed revision palatoplasty. At 6 months postoperative assessment, group A (with PRP application) showed significantly better grade of nasality (P = 0.024) and better endoscopic velopharyngeal closure (P = 0.016) than group B. Usage of autologous PRP in complete cleft palate repair is simple; effective; can decrease the incidence of oronasal fistula; and also significantly improves the grade of nasality and velopharyngeal closure, which decreases the need of further surgical intervention in cleft palate patients. 3b. Laryngoscope, 126:1524-1528, 2016.

Split-thickness skin grafting (STSG) is commonly employed for soft-tissue coverage because of its broad application for use, ease of harvest, and universal equipment. STSG healing proceeds through 3 stages: (1) anchorage, (2) inosculation, and (3) maturation. The success of the first 2 stages is critical to the overall success. Bolster dressings of various types are universally applied to create apposition of the skin graft with the granular bed, thereby preventing shearing forces and fluid accumulation until vascular ingrowth can occur. The application of autologous platelet-rich plasma (PRP) to STSG application sites has been recently described and theorized to provide immediate skin graft anchorage as well as inosculation of the STSG with nutrient-rich blood media. This study was performed to report the time to >or=90% primary healing of STSGs augmented with application of PRP in a high-risk patient population. The mean time to >or=90% STSG recipient site healing was 16 +/- 4.2 days, as determined by retrospective chart review and digital photograph analysis. The addition of PRP to STSG recipient sites seems to enhance primary healing and reduce healing time, likely as a result of shearing force reduction and enhancement of the wound environment with growth factors.

Platelet-rich plasma (PRP) is widely used for wound healing in medical care because of the numerous growth factors it contains. Traditionally, donor sites are left to heal with a primary dressing so wounds are not left open. However, a delay in healing accompanied by pain at a donor site is often seen. This study primarily throws light on the use of autologous PRP over split-thickness skin graft (STSG) donor sites to promote healing and reduce pain. The patients enrolled in this study in 2018-2019 were divided into two groups: the intervention group received autologous PRP applied topically at the donor site; in the control group, the wound was dressed traditionally. Pain scales were measured in the immediate postoperative period at six hours, 10 hours and 16 hours. The dressing was opened on the postoperative day 14 and observed for healing by an independent observer. A total of 100 patients were included in the study. Patients in the PRP group showed statistically significant faster healing at postoperative day 14 compared with the control group (p<0.05), who required dressings for 3-4 weeks postoperatively. Pain scale scores in the postoperative period were significantly less in the PRP group at six hours postoperatively compared with the control group (p<0.05). There was a reduced incidence of hypertrophic scar formation in the small number of patients in the PRP group who had developed hypertrophic scar previously. Application of PRP is a safe, cost-effective and easy method to achieve faster healing in graft donor site areas that are troublesome to both patients and doctors. It also reduces postoperative pain at donor sites. The authors recommend PRP is used more often in the management of donor sites for STSGs.

Objective – to study the character of ultra- structural changes in the tissue macrophages under the eff ect to complex of accessory factors promoting reparative process activation in the wound: ozone therapy, local application of autologous platelet-rich-plasma.Materials and methods. The patients were divided into three groups. The 1st group included 23 (32,85%) individuals who were treated by means of ozone therapy. The 2nd group included 23 (32,85%) patients treated by means of local platelet-rich plasma (PRP) therapy. The control group included 24 (34,28%) individuals who received a complex of therapeutic measures according to the generally accepted method. Surgery or all the patients was performed with maximum saving of the vessels in the plantar region, and the local treatment included topical vacuum therapy in the amount of 5-6 procedures. Electronic- microscopic examination used the fragments of tissue from the wound surface preserved in 2,5% glutaraldehyde solution on phosphate buff erі (рН – 7,2-7,4), followed by further processing in 1% anhydride solution. The material was dehydrated in increasing concentration alcohols and placed into araldite. The morphological structures were contrasted with a concentrated solution of uranyl acetate in the process of dehydration, and on the sections – with lead citrate. The sections 40-60 nm thick obtained by means of ultratome УМТП-3 were examined under the electron microscope TESLA БС-500. The specimens for examination were taken in the patients during dressings on the 7, 14 and 21-23 days of treatment. The dynamics of changes in the tissue macrophages was conducted by means of Astaldi principle generalizing percentage evaluation. It is a semi-quantitative method considering distinctive cytological changes determined in the similar amount of the cells examined (tissue macrophages).Results. Stimulation of the macrophage functional activity under the eff ect of ozone with destructive changes found in the cells without necrotizing damage was found to be explained by apoptosis mechanism involved as a positive factor in the regulation of local homeostasis at the completion of infl ammatory (exudative) phase of the wound process. Activation of phagocytic possibilities of the tissue macrophages with local application of autologous platelet-rich plasma occurs without any signs of apoptosis prevailing, and it is indicative of stimulation of their functional activity by antigenic or enzymatic mechanisms stimulating their functional activity.Conclusions. Stimulation of macrophage functional activity under ozone eff ect and availability of destructive changes in the cells without necrotizing damage can be explained by the involving of apoptosis mechanism as a positive factor in the regulation of local homeostasis at the completion of infl ammatory (exudative) phase of the wound process. Activation of phagocytic possibilities of the tissue macrophages with local application of autologous platelet-rich-plasma occurs without any signs of apoptosis prevailing, and it is indicative of stimulation of their functional activity by antigenic or enzymatic mechanisms stimulating their functional activity.Prospects of further studies. The results obtained confi rm and determine further necessity to conduct search innovations in the treatment of diabetic foot syndrome using the factors of physical and biological eff ect directed to the activation of a reparative process in the wound.

Background Failure of wound repair and dysregulated inflammation in considered to play a key role in the persistence of Crohn’s perianal fistulae (pCD). Few preliminary reports suggest that autologous platelet-rich plasma (PRP) can enhance wound repair and may be effective in treating pCD. Therefore, the aim of our study was to determine the efficacy of autologous PRP in the treatment of pCD. Methods A prospective, uncontrolled, single center study in a referral IBD center was conducted between July 2018 and March 2021. Adult Crohn′s disease patients with pCD failing on antibiotics, immune suppression and/or biologics were eligible for the study. All patients had non-cutting setons for a minimal period of 6 weeks prior study intervention. Autologous PRP was separated by centrifugation 60 ml of peripheral blood in Harvest SmartPrep© System at the time of operation. After the seton removing, internal openings were closed by PDS 2/0 single suture and PRP was injected close to internal openings and fistula tracts. Patients were examined at outpatient clinic at week 1, month 1, 3, 6 and 12. Any suspected side-effects of the treatment were noted. Treatment effect was assessed by perianal Crohn Disease Activity Index (PCDAI assessed at baseline, month 1, 3, 6, 12) and van Assche MRI score (assessed at baseline and month 6 and 12). The primary end-point was complete healing at month 6 defined as closure of all external fistula openings and absence of abscess on MRI. The secondary end-point was sustained response at month 12. Results In total, 25 patients (pts) with pCD were included (mean age 36 years, range 21-61; 15 men). The majority of pts were using antiTNF biologics (9 adalimumab, 9 infliximab), 4 pts were treated by ustekinumab, one by vedolizumab, two patients were on immunomodulators monotherapy. By March 2021, 24 patients finished the 6 months and 21 patients the 12 months follow-up. The primary end-point of complete healing at month 6 was reached by 18 out of 24 pts (75%). All but one patients with complete healing had persistent complete healing at 12 months follow-up. Baseline PCDAI (median 5, range 2-15) decreased significantly as early as at month 1 (median 1, range 0-8; p&amp;lt;0.001) and remained further stable over 12 months. Van Assche MRI score decreased significantly from median of 9 (range 3-18) at baseline to 5 (range 0-18) and 5.5 (range 0-18) at month 6 (p=0.001) and 12 (p=0.03); respectively. Conclusion Local application of autologous platelet-rich plasma leads to rapid healing of difficult-to-treat Crohn’s perianal fistulae in 75% of patients and this effect is sustained up to minimal period of one year.

Application of autologous platelet-rich plasma to enhance wound healing after lower limb revascularization: A case series and literature review

Improvement of reparative process of the chronic wounds with the insufficiency of peripheral blood suppling in patients suffering from diabetes mellitus is an important issue requiring further investigation. An optimal choice of surgery, effective renewal of blood supply and active stimulation of tissue repair on the cellular level are essential components of success treatment of this problem.Objective of research: From 2017 to 2020, the efficiency of one of the variants of organ-saving surgery performed on 210 patients with an ischemic-gangrenous form of diabetic foot syndrome was studied.Materials and methods. Control group included 104 patients (49.52%), were the treatment carried out in accordance with the standard scheme. The main group (106 patients - 50.47%) in addition to the standard therapy have used regional ozone therapy, vacuum sanitization and local application of autologous platelet-rich plasma (APRP).Results. These proposed measures reduced the period of clinical treatment to 24±1,2 days in the main group compared to 37±2,4 in the control one. 2 years later, patients of the main group confirmed the formation of a foot stump functionally adapted for walking with angular dislocation of fragments of the cuboid and scaphoid bones.Two years after foot amputation due to the ischemic-gangrenous form of diabetic foot syndrome (DFS), the amount of repeated above knee amputations was 1.8 times higher in the control group in comparison with the main group, which is indicative of a reasonable use of the complex of activate a reparative process in the wound.Conclusions: The suggested modification of the organ-saving and partial foot amputation in patients with IV degree of ischemia and DFS is indicative of a possibility to perform such kind of surgery as a variant of choice.The complex of proposed additional measures including regional ozone therapy, vacuum sanitization and local administration of autologous platelet-rich plasma activates a reparative process of a chronic foot wound and promotes an effective treatment of patients with ischemic-gangrenous form of DFS.