Abstract
The number of studies evaluating platelet-rich plasma (PRP) concentration has substantially grown in the last fifteen years. A systematic review on this field has been realized by evaluating in the identified studies the in vitro PRP concentration—also analyzing the platelet amount—and the in vivo PRP effects in tissue regeneration compared to any control. The protocol has been developed in agreement with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses-Protocols (PRISMA-P) guidelines. Multistep research of the PubMed, MEDLINE, Embase, PreMEDLINE, Ebase, CINAHL, PsycINFO, Clinicaltrials.gov, Scopus database and Cochrane databases has permitted to identify articles on different concentrations of PRP in vitro and related in vivo impact for tissue repair. Of the 965 articles initially identified, 30 articles focusing on PRP concentration have been selected and, consequently, only 15 articles have been analyzed. In total, 40% (n = 6) of the studies were related to the fixed PRP Concentration Group used a fixed PRP concentration and altered the platelet concentration by adding the different volumes of the PRP (lysate) to the culture. This technique led to a substantial decrease in nutrition available at higher concentrations. Sixty percent (n = 9) of the studies were related to the fixed PRP Volume Group that used a fixed PRP-to-media ratio (Vol/Vol) throughout the experiment and altered the concentration within the PRP volume. For both groups, when the volume of medium (nutrition) decreases, a lower rate of cell proliferation is observed. A PRP concentration of 1.0 × 106 plt/μL, appears to be optimal thanks to the constant and plentiful capillary nutrition supply and rapid diffusion of growth factors that happen in vivo and it also respects the blood decree-law. The PRP/media ratio should provide a sufficient nutrition supply to prevent cellular starvation, that is, PRP ≤ 10% (Vol/Vol) and thus best mimic the conditions in vivo.
Highlights
The number of studies evaluating platelet-rich plasma (PRP) concentration has substantially increased during the last fifteen years (2005–2020)
PRP is a concentrate of platelets and growth factors (GFs) obtained by the centrifugation of venous blood
All the studies consistently report that PRP may increase cell proliferation in vitro
Summary
The number of studies evaluating platelet-rich plasma (PRP) concentration has substantially increased during the last fifteen years (2005–2020). PRP is a concentrate of platelets and growth factors (GFs) obtained by the centrifugation of venous blood. It may be autologous or allogenic and generally, it is possible to distinguish the autologous PRP in two different products—Autologous activated PRP (AA-PRP) and autologous not-activated PRP (A-PRP). These products are considered routine for plastic surgeons and dermatologists with consolidated experience in regenerative medicine [1,2]. In the last fifteen-years, the PRP application has expanded to a wide range of clinical fields, including plastic surgery [4], trichology [5,6,7], dermatology [8,9], maxillofacial surgery [10], orthopedics [11] and others
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