The effect of topical application of platelet-rich plasma in controlling bleeding and sternotomy wound infection after cardiac surgery

Abstract

Background Bleeding and surgical wound infections after open heart surgery are associated with increased morbidity and mortality. These complications have devastating effects on patients’ recovery and a substantial economic effect on health care providers. There remains an incentive to reduce the risks further. Platelet-rich plasma (PRP) is a source of growth factors and cytokines, which can promote tissue healing and regeneration. Aim The aim of this study is to determine the effect of PRP on bleeding and surgical wound infection after cardiac surgery. Patients and methods A total of 34 patients were randomized into two groups: PRP group and control group. Overall, 30 ml of the patient’s autologous blood was centrifuged for 5 min to separate the red blood cells from the plasma. The plasma was then centrifuged for 10 min; the precipitate is the PRP. Activation of PRP was done by adding 1 ml of calcium gluconate to the syringe just before spraying the PRP in the operative field. After weaning the patient from cardiopulmonary bypass and before the insertion of sternal wires, the mediastinal cavity was irrigated with the PRP (30 ml of warm saline mixed with an equal amount of PRP) in group ‘A’ and saline only in group ‘B.’ Study end points were bleeding and blood transfusion. Results Wound discoloration occurred in 11.8% (two cases) in the control group; however, no wound discoloration was recorded in the PRP group, with P value of 0.145. Drainage (with mean drainage in control group was 473.53 ml and mean drainage in PRP group was 193.75 ml) and transfusion requirements (with mean transfusion requirements in control group was 1.5 pack and mean transfusion requirements in PRP group was 0.63 pack) showed a statistically significant difference between the two groups, in favor of the PRP group (P Conclusion Our results suggest that bleeding tendency, coagulation profile, and the incidence of blood transfusion are better with the application of PRP. Wound discoloration was better with the application of PRP.