Autologous Platelet Gel Research Articles

Role of Autologous Platelet Gel (APG) in Bone Healing: A Rabbit Study

Purpose: The aim of the present study is to evaluate the influence and efficacy of autologous platelets on bone regeneration in a rabbit defects model. Materials and Methods: A total of 12 critical size tibial defects were produced in six New Zealand rabbits: A total of six defects were filled with autologous platelet gel (APG) and six defects were maintained as untreated controls. No membranes were used to cover the bone osteotomies. The histology and histomorphometry were performed at four weeks on retrieved samples of both groups. Results: No complications were reported in any of the animals nor for the defects produced. A significantly higher lamellar and woven bone percentage was reported for the APG group with a lower level of marrow spaces (p < 0.05). Evidence of newly formed bone was found in the superficial portion of the bone defect of APG samples where no aspects of bone resorption were observed. Conclusions: The evidence of the present research revealed that APG increases new bone formation restricted to the cortical portion and induces more rapid healing in rabbit bone defects than in untreated defects.

Role of Platelet Rich Plasma in Healing of Chronic Leg Ulcers

Platelet-rich plasma (PRP) is characterized as a segment of the plasma part of autologous blood having a platelet fixation above standard. PRP likewise has been alluded to as platelet-improved plasma, platelet-rich concentrate, autologous platelet gel, and platelet releasate. To research the advantages of infusing platelet rich plasma in mending of constant leg ulcers. This is a solitary – focus, planned, randomized, controlled examination that was directed in General Surgery Department, Faculty of Medicine, Benha University incorporating 100 patients giving persistent leg ulcers and introduced to us between January 2018 to June 2018. This investigation was completed in 100 patients with ongoing leg ulcers were remembered for this examination, patients were arbitrarily partitioned in two equivalent gatherings An and B. The magnificent outcomes appeared in ongoing investigations have just served to affirm the great results depicted in our examination. In ten patients that we treated, the outcomes got following consummation of the uses of PRP were acceptable or phenomenal. The utilization of PRP in remedial cycles identified with Plastic, Reconstructive and Esthetic Surgery is presently a genuine alternative in generally open and private emergency clinics in numerous nations; circumstance that shows the advances that have happened over ongoing years in tissue recovery treatment.

A massive dose of allogeneic platelet gel for wound hemostatic therapy on patients with giant thoracic aortic aneurysm: report of 2 cases

Autologous platelet-rich plasma (PRP) or platelet gel (PG) has been widely used in clinical treatment. Allogeneic PRP or PG may also become a safe and effective alternative method. In this study, two cases with giant thoracic aortic aneurysm were reported where massive doses of allogeneic PG were used to spray the thoracic aortic aneurysm wall suture wrapped in artificial blood vessels, tumors blood vessel wall anastomotic site, and incision site of surgical operation. The volumes of 220 mL and 250 mL PG were applied on two patients respectively, to clot bleeding and decrease the mediastinal and pericardial drainage days after operation. The drainage tubes were pulled out on the 4th day after operation. The patients were transferred from ICU to a cardiothoracic surgery ward on the 4th and 5th day respectively. This study suggests that allogeneic platelet concentrate, as a source of PRP to prepare PG, may be used to promote and help the clotting and wound healing on surgical operation.

Platelet Gel in the treatment of generalized aggressive periodontitis: A case report

Aggressive periodontitis is a less prevalent, multifactorial disease which characteristically results rapid destruction of periodontium and early tooth loss. This is more frequently seen in systemically healthy younger age group of patients. Aggressive periodontitis can manifest in localized or generalized form. Generalized aggressive periodontitis is clinically characterized by loss of interproximal attachment of at least three permanent teeth apart from first molars and incisors. Conventional surgical procedure with autologous platelet Gel and systemic antibiotics were used successfully to treat and manage this case of generalized aggressive periodontitis. Keywords: Aggressive Periodontitis (AP), Generalized Aggressive Periodontitis (GAP). Autologous Platelet Gel (PG). Platelet Rich Plasma (PRP).

Evaluation of safety and efficacy of autologous topical platelet gel vs platelet rich plasma injection in the treatment of venous leg ulcers: A randomized case control study.

Various management options were tried for Chronic venous leg ulcers (VLUs) with no satisfactory results. Platelet-rich plasma (PRP) is promising in enhancing chronic wound healing by releasing various growth factors. We evaluated the safety and efficacy of topical platelet gel (PG) vs PRP injection in treatment of venous leg ulcers. 20 patients were treated with topical PG (group I), 20 patients received PRP injection (group II), and 20 patients were treated with saline dressing and compression as controls (group III) weekly for 6 weeks. Ulcer improvement was evaluated by pressure ulcer scale for healing (PUSH). Histopathological evaluation and immunohistochemical staining using anti-CD34 were performed before and after treatment. There was significant improvement in PUSH score in group (I) and (II) compared to group (III; P value: .001). However, there was no statistically significant difference in improvement between group I and II (P value = .83). However, topical PG was more effective in diabetics and PRP was more effective in long standing fibrosed ulcers. Histopathology showed reduction of the inflammatory cells infiltrates and well-formed granulation tissue with no difference in immunostaining. So, both topical PG and PRP injection were effective, low cost, and safe procedures in enhancing healing of chronic VLUs.

Evaluation of Different Autologous Platelet Concentrate Biomaterials: Morphological and Biological Comparisons and Considerations.

The field of regeneration interventions in oral and maxillofacial surgeries still represents a challenge for researchers and clinicians. Understanding the biological and morphological behaviour of human cells towards the materials used for the regeneration surgeries is key to successfully choosing and applying the appropriate biomaterials for specific clinical situations. The aim of the study was the biological and morphological evaluation of autologous platelet concentrate materials obtained with different protocols, in culture with human periodontal ligament fibroblasts (HPLF). The study design included the evaluation of Leukocyte-Platelet-Rich-Fibrin (L-PRF), Concentrated Growth Factors (CGF) and autologous platelet gel (APG) in contact with the HPLF cell line after 24 h, 72 h and 7 days of in vitro culture. Cell proliferation and, therefore, viability were evaluated with XTT assays. The morphological response of the cells was evaluated by light microscopy, scanning electron microscopy and confocal microscopy. The XTT assay showed an interesting response in the growth curve. In particular, the material that gave the best results was the CGF. The morphological data supported the XTT assay, showing the best results for the CGF and L-PRF. In conclusion, all the platelet-derived materials stimulated the onset of the growth of the HPLF cell line, making them promising options for periodontal regeneration interventions.

Guidelines on use of interventions to enhance healing of chronic foot ulcers in diabetes (IWGDF 2019 update).

The International Working Group on the Diabetic Foot (IWGDF) has published evidence-based guidelines on the prevention and management of diabetic foot disease since 1999. In conjunction with advice from internal and external reviewers and expert consultants in the field, this update is based on a systematic review of the literature centred on the following: the Population (P), Intervention (I), Comparator (C) and Outcomes (O) framework; the use of the SIGN guideline/Cochrane review system; and the 21 point scoring system advocated by IWGDF/EWMA. This has resulted in 13 recommendations. The recommendation on sharp debridement and the selection of dressings remain unchanged from the last recommendations published in 2016. The recommendation to consider negative pressure wound therapy in post-surgical wounds and the judicious use of hyperbaric oxygen therapy in certain non-healing ischaemic ulcers also remains unchanged. Recommendations against the use of growth factors, autologous platelet gels, bioengineered skin products, ozone, topical carbon dioxide, nitric oxide or interventions reporting improvement of ulcer healing through an alteration of the physical environment or through other systemic medical or nutritional means also remain. New recommendations include consideration of the use of sucrose-octasulfate impregnated dressings in difficult to heal neuro-ischaemic ulcers and consideration of the use of autologous combined leucocyte, platelet and fibrin patch in ulcers that are difficult to heal, in both cases when used in addition to best standard of care. A further new recommendation is the consideration of topical placental derived products when used in addition to best standard of care.

Autologous platelet-rich gel for facial rejuvenation and wrinkle amelioration: A pilot study.

The demand for safe and minimally invasive soft tissue augmentation procedures has increased. Recently, a novel injectable gel based on the autologous platelet rich in growth factor (PRGF) technology has been developed to provide long-term shape and volume stability. It can be customized into low (LVG) or high viscosity (HVG) gel forms to meet different dermatological requirements. The mechanical and biological properties of both gel forms have been evaluated. The clinical efficacy and safety of this autologous procedure were also evaluated. Growth factor content and biomechanical properties of both gel forms were determined. The in vitro biological capacity on human dermal fibroblasts proliferation was assessed. Clinical performance analysis over ten patients was evaluated by standardized macrophotographs, 3D topographic images, and ultrasound analysis over periocular and nasolabial areas. Both gel types showed similar growth factor concentration. HVG showed a higher stiffness profile indicating its suitability for deeper tissue defect viscosupplementation while LVG showed optimal rheologic characteristics for superficial volumization. Both gels showed a noticeable biostability after catalytic enzyme degradation. Both forms significantly increased the mitogenic activity of dermal fibroblasts. All patients referred to be highly satisfied and presented optimal clinical results after one month. Overall clinical improvement was maintained for 16weeks. At the end of the study, the ultrasound examination revealed a cutaneous regenerative effect. No adverse events occurred. This preliminary study suggests that autologous platelet gels have desirable mechanical and bioactive properties and allows moderate wrinkle reduction and efficient facial volume reposition with natural results.

Autologous blood as a source of platelet gel for the effective and safe treatment of oral chronic graft-versus-host disease.

Oral chronic graft-versus-host disease (cGvHD) impairs oral function and patients' quality of life. Some lesions are refractory to local and systemic immunosuppressive therapy, and new therapeutic modalities are required. The aim of the study was to assess the efficacy and safety of topical application of autologous platelet gel (PG) in patients with oral cGvHD. PG was prepared from autologous blood and applied on ulcerous lesions using an automated system. The oral cGvHD was assessed using the 273-point Oral Mucositis Rating Scale (OMRS) prior and after completion of the PG treatment. The overall response to treatment of particular topography expressed as the total score on OMRS was compared to total score on National Institutes of Health cGvHD Oral Mucosal Score (NIH OMS). The pain intensity was measured by the Numeric Pain Rating Scale (NRS). In five patients, 12 autologous blood collections were performed; median 3 (range 1-3) per patient, and 26 PG applications were performed; median 6 (range 2-8) per patient. PG applications reduced lesions in oral cGvHD: median OMRS total score was reduced for 43.2% (range 9.6%-47.3%), and median NIH OMS total score for 27.3% (range 20.0%-50.0%) from baseline values. Median of pain intensity reduction on NRS scale was 57.1% (range 50%-100%). No side effects were observed. Application of autologous PG in oral cGvHD showed as an efficient and safe treatment option for patients who do not respond to standard local treatment.

The use of platelet gel for repair of a cerebrospinal fluid fistula of the skull base (a case report and literature review)

Nasal liquorrhea is a serious problem in surgery of skull base tumors, which is associated with a high risk of purulent-septic complications. This paper presents a case of successful repair of a cerebrospinal fluid fistula with an autologous platelet gel in the postoperative period after removal of meningioma of the anterior cranial fossa base, which was accompanied by a purulent-inflammatory complication in the surgical wound area.

Impressive tissue regeneration of severe oral mucositis post stem cell transplantation using cord blood platelet gel

Platelet gel from cord blood (CBPG) is a recently developed blood component for topical use. We report a case of life-threatening mucositis after high-dose chemotherapy with fotemustine and cytarabine that was successfully treated with CBPG. A patient with non-Hodgkin lymphoma who was undergoing autologous hematopoietic stem cell transplantation developed severe oral and esophageal mucositis with severe bacterial sepsis and cytomegalovirus infection, causing prolonged neutropenia. CBPG was topically administered daily to the oral cavity. The CBPG was partially reabsorbed and partially swallowed. After 8 consecutive days of administration, the patient's oral mucosa markedly improved, showing restitutio ad integrum, and the patient's clinical status progressively improved. No side effects were seen after CBPG application. This case supports the need to conduct controlled studies comparing the efficacy of autologous and allogeneic platelet gel from adult and umbilical cord blood for the topical treatment of severe oral mucositis occurring after high-dose chemotherapy.

Assessment of autologous platelet gel injection in nonunited long bones

Aim Growing interest in nontransfusional hemoconcentrate use is evident. The aim of this study was to assess the effectiveness of autologous platelet gel injection in nonunited long bones. Settings and design This single-center prospective study was conducted on 20 patients with long-bone nonunions. Patients and methods Patients with clinical and radiological signs of long-bone nonunions and eligible for autologous donation were included. Autologous platelets were prepared in blood bank and activated with calcium gluconate and autologous thrombin shortly before injection. Fracture healing was evaluated clinically and with radiographic views in two planes at serial follow-ups of 6 weeks after injection and then every 4 weeks until healing was confirmed. Results The median time between injury and platelet gel injection was 8 months. Evidence of callus formation was seen in 17 (85%) patients by the end of 17th week; the remaining three patients failed to achieve union at 24 weeks’ follow-up. Conclusion Platelet gel injection is a safe nonoperative modality for nonunited long bones.

Abstract: Filling Prominent Nasolabial Fold Appliying Platelet Rich Plasma(PRP) Gel

INTRODUCTION: PRP gels has been used for a few years in facial plastic surgery to decrease hematoma formation, seroma formation, postoperative swelling, and healing time.1 Despite having a volume itself, PRP gel hasn’t ever used as a filling material in aesthetic plastic surgery practice. The gel has not only volume advantage but also the benefits of PDGF and cytokines. Due to this, we used the PRP gel as a filling material for nasolabial folds. MATERIALS AND METHODS: 3,W patients were refered to our clinic with prominent nasolabial fold due to aging. Mean age was 46 (42- 48). We obtained PRP gel from their own blood without anesthesia by embryologists. Blood was centrifuged, and the platelet and fibrinogen rich plasma component were harvested. It was applied in policlinic doing injection with 18 G canule about 2 cc. Patients were visited at 1th week, 1th, 3th and 6th months. Photos and videos were taken. For one patient MR imaging was performed. RESULT: In one patient PRP gel was seen at MR imaging at nasolabial fold area at 1th month.In physical examination, gel was perceivable. Nasolabial fold depth was reduced at static and dynamic visualization and their face were looked younger. CONCLUSION: Prominent nasolabial folds due to ageing are a major aesthetic concern among women. There are many treatments like injection of artificial fillers, fat grafting operations, facelift procedures. And the most popular is fat graft. We shared our patients whom we used PRP gel for filling the nasolabial fold. PRP gels has been used for a few years in facial plastic surgery to decrease hematoma formation, seroma formation, postoperative swelling, and healing time. Their use as a biological dressing after laser resurfacing has demonstrated faster healing and decreased erythema. The application of platelet gels to fat grafts enhances the longevity when injected for contour augmentation. When platelet gel is used in conjunction with sutures it provides for greater tensile strength. PRP gel hasn’t ever used as a filling material in aesthetic plastic surgery practice. In this study we used PRP gel as a tissue fiiler. It an easy harventing, cost effective method and the main advantage is restoring the problem with autologous tissue even easier than fat graft. DISCLOSURE/FINANCIAL SUPPORT:None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. REFERENCES 1 Edward P. Melmed, MD, Autologous Platelet Gel in Plastic Surgery. Aesthetic Surgery Journal. 2001:21:377–379

Platelet-Rich Plasma for the Treatment of Clean Diabetic Foot Ulcers

Diabetic foot ulcer is considered as a major health problem that predisposes to limb amputation. Among the different methods to achieve ulcer healing, platelet-rich plasma (PRP) gel is gaining popularity. It is thought to stimulate wound closure by providing essential growth factors for healing. This study aims to evaluate the value of autologous PRP gel in the treatment of diabetic ulcers. The study included 56 patients of both sex from 18 to 80years, with clean chronic diabetic foot ulcers divided into 2 equal groups. The first group was treated by antiseptic ointment dressing, and the second group was treated by autologous platelet gel. PRP together with thrombin were prepared by centrifugation at each dressing session. Thrombin and calcium chloride were used to activate the PRP. The formed platelet gel was applied to the wound twice weekly. Statically significant increase in healing rate was found in the PRP-treated group, and complete healing was achieved in 86% of them in comparison to 68% of the control group. In the study group, rate of healing per week was greater during the first 8weeks and starts to decline afterward. The use of platelet gel showed a lower rate of wound infection. Autologous platelet gel is more effective than the local antiseptic dressing in terms of healing rate and prevention of infection in clean diabetic ulcers.

A meta-analysis of platelet gel for prevention of sternal wound infections following cardiac surgery.

Deep sternal wound infection and bleeding are devastating complications following cardiac surgery, which may be reduced by topical application of autologous platelet gel. Systematic review identified seven comparative studies involving 4,692 patients. Meta-analysis showed significant reductions in all sternal wound infections (odds ratio 3.48 [1.08-11.23], p=0.04) and mediastinitis (odds ratio 2.69 [1.20-6.06], p=0.02) but not bleeding. No adverse events relating to the use of topical platelet-rich plasma were reported. The use of autologous platelet gel in cardiac surgery appears to provide significant reductions in serious sternal wound infections, and its use is unlikely to be associated with significant risk.

Soft Tissue Augmentation with Autologous Platelet Gel and β-TCP: A Histologic and Histometric Study in Mice.

Background. Facial aging is a dynamic process involving both soft tissue and bony structures. Skin atrophy, with loss of tone, elasticity, and distribution of facial fat, coupled with gravity and muscle activity, leads to wrinkling and folds. Purpose. The aim of the study was to evaluate microporous tricalcium phosphate (β-TCP) and autologous platelet gel (APG) mix in mice for oral and maxillofacial soft tissue augmentation. The hypothesis was that β-TCP added with APG was able to increase the biostimulating effect on fibroblasts and quicken resorption. Materials and Methods. Ten female, 6–8-week-old black-haired mice were selected. β-TCP/APG gel was injected into one cheek; the other was used as control. The animals were sacrificed at 8 weeks and histologically evaluated. Results. The new fibroblast was intensively stained with acid fuchsin and presented in contact with β-TCP. At higher magnification, actively secreting fibroblasts were observed at the periphery of β-TCP with a well differentiated fibroblast cell line and blood vessels. Acid fuchsin stained cutaneous structures in pink: no epidermal/dermal alterations or pathological inflammatory infiltrates were detected. The margins of β-TCP granules were clear and not diffused near tissues. Conclusion. APG with β-TCP preserves skin morphology, without immune response, with an excellent tolerability and is a promising scaffold for cells and biomaterial for soft tissue augmentation.

Injection of Autologous Fat Alone and in Combination With Autologous Platelet Gel for Nasolabial Fold Augmentation

Background: Recently, soft tissue augmentation has become popular due to development of convenient techniques. Autologous fat is one of the safest fillers for this purpose. Moreover, healing effects of autologous platelet gel on acute and chronic human skin wounds have been shown in recent studies. Objectives: In this study, the effect of subcutaneous injection of autologous fat alone and in combination with platelet gel was compared in the treatment of nasolabial skin folds in nine cases. Patients and Methods: Nine volunteers (three males and six females) were referred to the dermatology clinic of Rasoul-e-Akram hospital. For each patient, one side of the lateral nasolabial folds underwent injections with the combination of autologous fat and platelet gel and the other side with autologous fat alone. Improvement of nasolabial fold was monitored by clinical assessment and digital photographs over a six-month period. Results: All patients experienced improvement in the wrinkles of the side treated by the combination therapy compared to the other side. In addition, less complication was observed in the side that underwent combination therapy. Conclusions: Our study showed that autologous fat in combination with platelet gel might have better cosmetic results as well as lesser complications in the healing of nasolabial wrinkles. However, the findings of this pilot study should be examined in further studies with larger sample size.

The role of platelet gel in osteoarticular injuries of young and old patients.

BackgroundThe use of autologous platelet gel in orthopedics is effective in accelerating the healing process of osteochondral, muscle, tendon and ligament lesions. The aim of our study was to verify whether the variability in response to infiltration with platelet gel was dependent on the underlying disease treated, sex and age of the patients. During four years, 140 patients have been treated for musculoskeletal injuries by infiltration of gel platelet and lysate platelet obtained from autologous thrombin, with echo-ultrasound guided. The response to treatment was assessed at different time points T0, T1, T2 with respect to pain estimation (VAS), joint mobility (ROM scale) and echo-ultrasound evaluation. This data collection has allowed classifying the response to treated lesions in three categories: NR (no response), PR (partial response), CR (complete response).ResultsThe data here reported showed that the ability to physical recovery response is evident in tendon injuries, while the large joints injuries gave a poor response. Almost all patients showed a significant pain relief after the first infiltration, but in terms of echo-ultrasound evaluation and tissue repair, only the muscle and tendon injuries showed hyperechoic areas, signs or evidences of repair. Concerning the correlation between response to infiltration with platelet gel and gender/age of the patients, the clinical results appear not influenced by the age and the gender of the patient.DiscussionOur data indicate that, pain relief and ability to physical recovery of muscles, tendons and ligaments depend on tissue repair clearly visible by echo ultrasound evaluation. On the other hand tissue repair seems not occur in the large joints (hip and knee) where arthritis and /or corrosion of articular cartilage cannot be repaired and the only relief is exclusively linked to the reduction of periarticular inflammation (reduction of the inflammatory leakage and signs).

Platelet activation using electric pulse stimulation: growth factor profile and clinical implications.

Autologous platelet gel therapy using platelet-rich plasma has emerged as a promising alternative for chronic wound healing, hemostasis, and wound infection control. A critical step for this therapeutic approach is platelet activation, typically performed using bovine thrombin (BT) and calcium chloride. However, exposure of humans to BT can stimulate antibody formation, potentially resulting in severe hemorrhagic or thrombotic complications. Electric pulse stimulation using nanosecond PEFs (pulse electric fields) is an alternative, nonbiochemical platelet activation method, thereby avoiding exposure to xenogeneic thrombin and associated risks. In this study, we identified specific requirements for a clinically relevant activator instrument by dynamically measuring current, voltage, and electric impedance for platelet-rich plasma samples. From these samples, we investigated the profile of growth factors released from human platelets with electric pulse stimulation versus BT, specifically platelet-derived growth factor, transforming growth factor β, and epidermal growth factor, using commercial enzyme-linked immunosorbent assay kits. Electric pulse stimulation triggers growth factor release from platelet α-granules at the same or higher level compared with BT. Electric pulse stimulation is a fast, inexpensive, easy-to-use platelet activation method for autologous platelet gel therapy.

Employment of autologous platelet gel in patients with skin ulcers correlated to the phenomenon of Raynaud

Employment of autologous platelet gel in patients with skin ulcers correlated to the phenomenon of Raynaud