Autologous Platelet-rich Fibrin Matrix Research Articles

Surgical and Biological Treatment with a Platelet-Rich Fibrin Matrix for Patellar Tendinopathy: Clinical Outcomes and Return to Sport at 2-Year Follow-Up.

Patellar tendinopathy (PT) involves anterior knee pain and functional. Platelet-rich fibrin matrix (PRFM) is a promising biological therapy for tendinopathies. We examined a cohort of PT patients treated with tendon debridement and autologous PRFM at the 24-month follow-up to assess whether the combined treatment facilitated return to sports and yielded satisfactory clinical and functional scores. Baseline and 24-month visual analogue scale (VAS), Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P), Tegner Activity Scale (TAS), and Blazina scores were compared to evaluate treatment effectiveness. The Friedman test was used to compare repeated observations of VAS, VISA-P, TAS, and Blazina Score values. Return to sport rate, Tampa Scale of Kinesiophobia (TKS) score and patient satisfaction were collected at 24 months. The postoperative clinical scores demonstrated significant improvement compared with their preoperative values (all p < 0.001). Specifically, the VISA-P score was 80.32 (±20.58), 92.10% of patients had resumed sports activities and patient satisfaction was 9.21 (±1.21) at 24 months. Surgical debridement and autologous PRFM application in patients with chronic PT resulted in a higher rate of return to sports when compared to solely surgical treatment, significantly improved clinical outcomes and excellent patient satisfaction at 24 months.

Applying additional autologous platelet-rich fibrin matrix or serial platelet-rich plasma to microfracture technique increases the quality of the repaired cartilage.

The aim of the present study is to investigate and compare the effects of biological adjuvants (platelet-rich plasma, platelet-rich fibrin matrix) and microfracture technique individually and in combination on full thickness chondral defects in a rabbit model. A total of 60 New Zealand White rabbits were randomly divided into six groups according to treatment modality as follows: control (C), microfracture (MF), platelet-rich plasma (PRP), platelet-rich fibrin matrix (PRFM), platelet-rich fibrin matrix after microfracture (MF + PRFM) and platelet-rich plasma after microfracture (MF + PRP) groups. The cartilage repair tissue was assessed histologically via International Cartilage Repair Score (ICRS) and macroscopically via ICRS macroscopic assessment scale. It was shown that overall macroscopic scores of the groups with MF were higher than those of the groups without MF. The cell morphology observed in the defect areas was mostly characterized with non-chondrocyte cells in the groups without MF, whereas chondrocyte cells mostly prevailed in the groups with MF. There was a greater integration through the cartilage-like tissue in the MF + PRP and MF + PRFM groups. The control group showed either fissures or fissures partially filled with fibrous tissue. When the groups were individually examined, there were statistically significant differences between the control and MF groups (p = 0.002), between the control and MF + PRFM groups (p = 0.001), between the control and MF + PRP groups (p < 0.001), between the PRFM and MF + PRFM groups (p = 0.014) and between the PRFM and MF + PRP (p = 0.023) groups in terms of histological evaluation scores. The application of PRP and PRFM in combination with MF treatment exhibited a positive impact on the repair and restoration of cartilage, and produced better outcomes than the individual use of PRP and PRFM. Nevertheless, in the treatment of full thickness chondral defects, the use of PRFM injection is recommended, which is performed intraoperatively at a single time and with no difficulty of repeating after surgery, instead of serial PRP injections based on the macroscopic and histological results obtained in the present study indicating that there was no significant difference between the use of these two adjuvants.

Plasma or Fibrin Matrix? A Comparative Study between PRP versus PRFM Therapy in Diabetic Foot Ulcer

Introduction: Diabetic foot ulcer is one of the most common conditions encountered in surgical OPD. The incidence of a diabetic foot ulcer is around 15% among the diabetic population. Around 80% of non-traumatic amputation is due to chronic diabetic foot ulcer. Recent advances are made in treating wounds in which platelet-rich plasma (PRP) and platelet rich fibrin matrix (PRFM) therapy have proven beneficial. Materials and Methods: A prospective study was conducted from February 2021 to February 2023, for a period of 2 years which included 42 patients. Group A received autologous platelet rich plasma therapy (PRP) and group B received autologous platelet rich fibrin matrix therapy (PRFM) each consisting of 21 patients. Results: PRFM Group showed better reduction in ulcer size compared to respective PRP Group, and demonstrated statistically significant p-values. Around 47% of the subjects had complete closure of the ulcer after 5 sessions of PRP dressing while it was 90% with PRFM dressing.

Return to Sports and Functional Outcomes after Autologous Platelet-Rich Fibrin Matrix (PRFM) and Debridement in Midportion Achilles Tendinopathy: A Case Series with 24-Month Follow-Up

(1) Background: Achilles tendinopathy (AT) is characterized by load-induced tendon pain, stiffness, and functional impairment that may affect the tendon midportion or insertion. Platelet-rich fibrin matrix (PRFM) is a promising adjunctive therapy for AT. We analyzed 24-month pain and functional outcomes in a cohort of patients managed by tendon debridement and autologous PRFM application to determine whether the combined treatment ensured an early return to sports/work and satisfactory clinical outcomes and functional scores. (2) Methods: The 24-month outcomes of 32 sport-practicing patients with chronic midportion AT treated with debridement and autologous PRFM were evaluated in terms of time to return to sports/work. The AOFAS and VISA-A were computed preoperatively and at 6 and 24 months. Blazina scores were evaluated preoperatively and at 6 months; ankle range of motion was assessed at 1, 6, 12, 24 months; and patient satisfaction was assessed at 24 months. (3) Results: Altogether, all patients had resumed their sport(s) activity, at the same or higher level, after 25.41 days (±5.37). Regarding work, all patients were able to return to their jobs after 16.41 days (±2.43). Ankle dorsiflexion and plantarflexion increased significantly: the AOFAS rose from 54.56 (±6.47) to 97.06 (±4.06) and 98.88 (±2.21) at 6 and 12 months, respectively, and the mean VISA-A score rose from 69.16 (±7.35) preoperatively to 95.03 (±4.67) and 97.28 (±2.43) at 6 and 12 months, respectively, after treatment. There were no complications. Most (90.62%) patients were very satisfied. (4) Conclusions: In symptomatic midportion AT, surgical debridement and autologous PRFM ensured a fast return to sports/work (4 weeks), significantly improving AOFAS and VISA-A and Blazina scores already at 6 months and providing excellent clinical outcomes at 24 months.

A Comparative Study on Therapeutic Efficacy of Autologous Platelet-rich Plasma, Autologous Platelet-rich Fibrin Matrix, Recombinant Human Epidermal Growth Factor, and Collagen Particles in Nonhealing Leg Ulcers.

Nonhealing leg ulcers are challenging to manage and cause significant patient morbidity. To promote healing, newer techniques focus on delivering/enhancing dermal matrix components. The aim of this study was to compare the therapeutic efficacy of autologous platelet-rich plasma (PRP), autologous platelet-rich fibrin matrix (PRFM), recombinant human epidermal growth factor (rhEGF), and collagen particles in treating nonhealing leg ulcers. Open, randomized prospective study was conducted in a single tertiary center over 2 years where after fulfilling the criteria, randomization was done into four groups. Group A: Autologous PRP (double spin, manual method, weekly); Group B: Autologous PRFM (weekly); Group C: rhEGF (daily application); and Group D: Collagen particles (weekly) along with cleansing, debris removal, and wound dressing. Treatment endpoints were complete healing/6 months of treatment, whichever was earlier. Follow-up was done two weekly by clinical assessment, photographs, and measurement of the ulcer area. Epi info 7 software was used for statistical analysis. A total of 48 patients completed the study, 12 in each group, with mean age: 42.37 ± 4.56 years and male-to-female ratio 2.6:1. Underlying etiology was varicosities (43.75%), traumatic (25%), diabetes (22.91%), and leprosy (8.34%). At baseline, all groups were comparable in terms of patient and ulcer characteristics. Complete healing was seen in 79.17% at the end of 12 weeks: 91.67% of patients from Groups A and B each, and 66.67% from Groups C and D each. The mean time to complete healing was 6.9 ± 2.5 weeks, the least in Group B (4.73 ± 2.3 weeks). Differences between excellent (≥75%) ulcer healing across all groups were statistically significant at the end of 8 weeks where Group B showed maximum improvement. No major adverse events were seen. PRFM resulted in relatively faster ulcer healing compared with other modalities.

To Compare the Efficacy and Safety of Autologous Non-cultured Non-trypsinized Keratinocyte and Melanocyte Grafting (Jodhpur Technique) with Autologous Platelet-Rich Fibrin Matrix (PRFM) in the Treatment of Chronic Non-healing Ulcer.

Background:Chronic non-healing ulcers (NHUs) are often associated with some underlying pathology which prevents timely healing thus increasing the patients morbidity and healthcare expenses. Autologous non-cultured non-trypsinized keratinocyte and melanocyte grafting also known as Jodhpur technique (JT), an epidermal graft and autologous platelet-rich fibrin matrix (PRFM) are newer modalities with promising results.Aims:To compare the efficacy and safety of JT and autologous PRFM in the treatment of chronic NHU. Design: A prospective hospital based interventional study conducted on 50 patients of chronic NHU attending the dermatology outdoor of a tertiary level government hospital.Materials and Methods:After taking clearance from the institutional ethical committee, the patients were enrolled into 2 groups of 25 each. JT was done on group A and autologous PRFM on group B and their efficacy and safety compared.Statistical Analysis:Chi square test was used to analyze categorical variables summarized as number and percentage while continuous variables were analyzed using student t-test for intergroup comparison.Results:In Group A, the mean time to ulcer healing was 6.17 ± 2.17 weeks while 6.43 ± 2.33 weeks in Group B. No side effects were found in either group.Conclusion:Both the techniques fair equally in terms of wound healing time and safety but required multiple sittings in group B and a single session in group A.

Comparison of Autologous Platelet-Rich Fibrin Matrix and Transplantation of Autologous Noncultured Epidermal Cell Suspension in the Treatment of Chronic Non Healing Ulcer: Randomized Comparative Study.

Chronic non-healing ulcer causes significant morbidity, high cost and reduced quality of life. To compare autologous platelet-rich fibrin matrix and transplantation of autologous non-cultured epidermal cell suspension in the treatment of chronic non-healing ulcers. The study was single-centre, prospective, randomised comparative study conducted in a tertiary care center in North India. Patients with chronic non-healing ulcer were included and randomly divided into two treatment groups- Group 1: Platelet-rich fibrin matrix (PRFM) procedure was done every 2 weeks with maximum three sittings and in Group 2: Transplantation of autologous noncultured epidermal cell suspension (NCES) procedure was done once. Follow-up was done every 2 weeks for 8 weeks then monthly for up to 5 months to evaluate the healing of the ulcer. The data were analysed by statistical package for social science (SPSS) trial version 22. To find out a significant difference in mean value between groups, the Chi-square test, student's t-test, and Mann-Whitney U test were used. A total of 41 patients were included in the study. Complete healing of ulcers occurred in 89.5% of the patients in the PRFM group and 93.8% of the patients in the NCES group at the end of 5 months (P = 0.33). The mean duration of complete healing in PRFM was 1.7 months and in NCES was 2.13 months (P = 0.20). Both procedures were effective, and there was no significant difference between the two procedures.

The use of autologous platelet-rich fibrin matrix combined with meniscal repair in the treatment of parameniscal cyst: clinical results and cyst recurrence after 2-year of follow up

PurposeParameniscal cysts are associate with horizontal meniscal tears. Arthroscopic meniscal repair and the excision of the cyst by mini-open approach represent a valid treatment. However, the recurrence of cyst is still a current issue. Therefore, biological factors may be considered to promote the biological repair and avoid recurrence. The aim of the present study was to report the clinical results and the rate of recurrence of the cyst after minimum 2-year of follow up in a cohort of patients treated by meniscal repair and autologous platelet-rich fibrin matrix augment.MethodsPatients with lateral parameniscal cyst undergoing arthroscopic meniscal repair and autologous platelet-rich fibrin matrix augment between 2016 and 2019 were retrospectively reviewed in March 2021. Inclusion criteria were absence of prior surgery on the affected knee with minimum 2-year of follow-up. Exclusion criteria were concomitant ligament lesions, rheumatic diseases and knee osteoarthritis. After reviewing the database, each selected patient was contacted and asked to participate in the study; at the follow-up evaluation all patient signed an informed consent. Tegner-Lysholm knee score, IKDC and NRS were collected before surgery and at follow-up.ResultsThis study included 15 patients (8 male) with mean age of 32.8 years old. No recurrence of the cysts was observed. The Tegner-Lysholm knee score and IKDC subjective scores increased respectively from 41.3 ± 5.4 and 37.6 ± 5.1 at baseline to 92.3 ± 4.6 and 89.4 ± 2.6 at the final follow up. Concerning pain relief, the Numeric Pain Rating Scale (NRS) displayed a significant improvement reaching at the follow up a score of 1,3 ± 1.1 in comparison to 6.8 ± 0.9 at the baseline.ConclusionSurgical management of symptomatic lateral parameniscal cyst with cyst excision, autologous PRP membrane application and meniscus repair demonstrated excellent subjective clinical outcome with any cyst reoccurrence.Level of evidenceIII, retrospective cohort study.

Autologous Platelet-Rich Fibrin Matrix–Augmented Repair for Parameniscal Cysts: Surgical Technique

Parameniscal cysts are defined as an internal disorder of the knee joint. It is known that parameniscal cysts are associated with horizontal meniscal tears that could lead to the collection of synovial fluid within the cyst. Despite the treatment of meniscal tears, cyst recurrence is still an issue that needs to be addressed. In this regard, there has been an increasing interest in the use of biologic agents to enhance the vascularity and healing of the meniscus. Preliminary results for biologic therapeutic agents, such as growth factors, bone marrow, and aspirate concentrate, have been encouraging. However, these options are more demanding in regards to time, financial burden, resources, and so on. Autologous platelet-rich plasma is readily available, easy to use, affordable, and minimally invasive. This Technical Note will describe a step-by-step and reproducible technique for the harvesting, preparation, and use of an autologous platelet-rich fibrin matrix used to augment the healing of meniscal repairs.

A Comparative Study on Therapeutic Efficacy of Autologous Platelet Rich Fibrin Matrix Versus Zinc Oxide And Phenytoin Paste in Non Healing Ulcers.

Context:A non-healing ulcer occurs due to multiple causes and possesses a great impact on the quality of life. Autologous platelet-rich fibrin and the application of a triple combination paste (zinc oxide, phenytoin, and mupirocin ointment) have emerged with a good response in the treatment of non-healing ulcers.Aims:To compare the therapeutic efficacy of autologous platelet-rich fibrin matrix versus the triple combination paste (zinc oxide, phenytoin, and mupirocin ointment) in non-healing ulcers.Settings and Design:Hospital-based interventional comparative study.Materials and Method:Twenty-four patients with non-healing ulcers were randomly divided into two groups. One group received platelet-rich fibrin (PRF) therapy every week for up to 5 weeks and the second group applied triple combination paste (zinc oxide, phenytoin, and mupirocin ointment) again for 5 weeks. In the end, the ulcer area was measured.Statistical Analysis Used:Student's paired t-test was used to evaluate the correlations between variables. A P-value of < 0.05 was considered significant.Results:Group A showed a mean reduction in the ulcer area by 8.26 mm2 (75.99%). Group B showed a mean reduction in the ulcer area by 4.799 mm2 (47.75%), which was statistically significant with a P-value of 0.004.Conclusion:We conclude that autologous platelet-rich fibrin matrix is much more effective than the triple combination paste (zinc oxide, phenytoin, and mupirocin ointment) in the treatment of non-healing ulcers.

To Evaluate the Efficacy and Safety of Autologous Platelet Rich Fibrin Matrix in the Treatment of Non-Healing Ulcer of Various Aetiology

To Evaluate the Efficacy and Safety of Autologous Platelet Rich Fibrin Matrix in the Treatment of Non-Healing Ulcer of Various Aetiology

Efficacy of autologous platelet rich fibrin matrix in the management of non-healing ulcers

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Non healing ulcers have a worldwide prevalence of 1.9%-13.1% with lower extremity being the commonest site. They are difficult to manage for the physician and frustrating for the patient due longer duration of treatment, cost, unsatisfactory outcomes and impairment caused due to them. Standard conventional management may fail at times and hence growth factors derived from platelets have been tried in the management of these ulcers. The purpose of our study was to evaluate the efficacy of platelet rich fibrin matrix (PRFM) in treatment of these ulcers.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Twelve patients with fifteen non-healing ulcers more than 3 months duration were included in the study. 10cc of venous blood was withdrawn in plain tube without anti-coagulants and centrifuged at 1500 rpm for 14 minutes as early as possible as per advanced PRF protocol. Middle layer of PRFM was applied to the clean ulcer followed by a secondary dressing. All patients received PRFM sittings every 7-10 days or till ulcer healed. Baseline photographs and measurements of length, breadth and depth were taken to calculate the area of ulcer at every sitting.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The average percentage reduction in area and volume of the ulcer was 95.84% and 98.18% respectively at the end of six sittings. Twelve out of fifteen ulcers showed complete healing by 6 weeks, while three ulcers showed significant improvement but did not heal completely. The procedure was safe, well tolerated without any side effects.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Platelet rich fibrin matrix is a novel modality and an ideal, safe, affordable therapeutic option for non-healing wounds of varied causes.&lt;/p&gt;

IN VITRO EVALUATION OF MECHANICAL AND STRUCTURAL PROPERTIES OF LEUKOCYTE-PLATELET-RICH FIBRIN AND PLATELET-RICH FIBRIN MATRIX

Objectives: The aim of this study was to investigate the mechanical properties as well as the structural analysis of autologous platelet-rich fibrin matrix (PRFM) as compared to autologous leukocyte-platelet-rich fibrin (L-PRF). Materials& Methods: Sixty three cubic centimeters (cc) venous blood was obtained from 10 male volunteers. Twenty seven cc were used to prepare 3 specimens of L-PRF (group 1), twenty seven cc were used to get 3 specimens of PRFM (group 2) and nine cc for whole blood analysis. After centrifugation, blood analyses were performed on the residual plasma after collecting L-PRF and PRFM. The L-PRF and PRFM membranes were processed for examination by light microscopy and transmission electron microscopy (TEM) and their mechanical properties were measured by a universal testing machine. Results:Tensile strength and maximum tensile strain of L-PRF group was significantly higher than PRFM group (p < 0.01). PRFM group was significantly stiffer than L-PRF group (p < 0.01). Light microscopy revealed that the platelets were less but more equally distributed in the PRFM than L-PRF. The border between the cellular components and the fibrin network appeared thicker in the PRFM samples than in the L-PRF samples and shows a highly organized network with continuous integrity. TEM showed that both membranes contained two components: a fibrillar material similar to fibrin filaments, and a cellular component that contains human platelet cells. TEM analysis demonstrated that PRFM membrane had more nonactivated platelets.Conclusion: The present study shows that the structural and mechanical properties of PRFM may fit characteristics desirable for GTR procedures more than that of L-PRF.

Autologous Platelet-rich Fibrin Matrix in Non-healing Trophic Ulcers in Patients with Hansen's Disease.

Background:Non-healing trophic ulcers in Hansen's disease patients is one of the major causes for disability. It has been shown that autologous platelet-rich fibrin matrix (PRFM) is effective in healing chronic non-healing leg ulcers.Aim:The objective of this study is to demonstrate the efficacy of autologous platelet-rich fibrin matrix (PRFM) in non-healing trophic ulcers in patients treated for Hansen's disease.Design:A prospective study.Setting:An institution-based clinic.Participants:Seven treated patients with Hansen's disease, with a mean age of 38.33 years, with nine non-healing trophic ulcer of more than 6 weeks duration.Measurements:Photographs were taken before treatment and at every subsequent sitting. Area and volume were calculated at baseline and every subsequent sitting till the closure was achieved.Materials and Methods:The healthy ulcers were treated with PRFM at weekly intervals, repeated once a week for a maximum of five sittings as per requirement.Results:The mean percentage improvement in the area was 93.52%, and volume was 97.74% at the end of the second sitting. All ulcers closed by a maximum of five sittings. No adverse events were noted.Conclusion:PRFM for the treatment of trophic ulcers in treated patients with Hansen's disease is a feasible, safe, simple and inexpensive method.

A comparative biomechanical study of repaired tendons wrapped with two biological matrices in Bucks

This study is planned to evaluate the efficacy of two biological matrices represented by autologous platelet rich fibrin matrix, as well as a cross linked decellularized caprine pericardial extracellular matrix on enhancing healing of the experimentally severed superficial digital flexor tendon in a goat model. It was carried out on 48 adult apparently healthy bucks, which were divided randomly into three equal groups. Under the effect of sedative and local ring block anesthesia, superficial digital flexor tendon was severed at the mid metacarpal region of the right forelimb. In the first control group, tenorrhaphy was performed and left without additives. While in the second group the tenorrhaphy site was wrapped with a previously prepared autologous platelet rich fibrin strips, as well as in the third group the tenorrhaphy site was wrapped with a cross linked decellularized pericardial extracellular matrix strip which was prepared from the whole fresh caprine pericardium obtained from the slaughter house. Both matrices were fixed in their position at the tenorrhaphy site by few interrupted stitches. The biomechanical evaluation of the operated tendon indicated an increase in tensile strength with time in all groups, but the comparisons among groups showed a significant (P≤0.05) increase at day 15 in both treated as compared to control animals. On day 45 the pericardial extracellular matrix group showed a significant increase in tensile strength as compared to platelet rich fibrin matrix and control groups, but at day 75 there were no differences among groups, at day 180 the pericardial extracellular matrix group showed a significant increase in the tensile strength as compared to platelet rich fibrin matrix and control groups. In conclusion, both biological matrices led to improvement in the biomechanical properties of the operated tendons with time.

PRFM enhance wound healing process in skin graft.

Facial plastic and reconstructive surgery often used skin graft on defects that cannot be covered primarily by a local flap. However, wound healing using skin graft is slow, most of the time the graft is contractured and the take of graft is not optimal. Platelet rich fibrin matrix (PRFM) is a new generation of concentrated platelets that produce natural fibrin and reported to speed up the healing process. Application of PRFM in the skin graft implants is expected to increase the survival of the graft. We used porcine as animal models to elucidate the effect of autologous PRFM on wound healing in full-thickness (FTSG) and split-thickness (STSG) skin grafts. Survival level of the skin graft was determined by using ImageJ software based on the formation of collagen type 1 and graft take. We observed that the use of PRFM in FTSG and STSG increased type 1 collagen formation. We also found that PRFM addition in STSG gave the best skin graft take.

Evaluation of the effect of Autolougues Platelet Rich Fibrin Matrix on osseointegration of the titanium implant immunohistochemical evaluation for PDGF-I&IGF-A

Platelet-rich fibrin (PRF) is a simple, low cost and minimally invasive way to obtain a natural concentration of autologous growth factors and is currently being widely experimented in different fields of medicine for its ability to aid the regeneration of tissue with a low healing potential. Fields of application are sports medicine, orthopedics, dentistry, dermatology, ophthalmology, plastic and maxillofacial surgery, etc. The rationale for using platelets in so many fields for the treatment of different tissues is because PLTs constitute a reservoir of critical GFs and cytokines, which may govern and regulate the tissue healing process that is quite similar in all kinds of tissues. Materials and Methods: Screw titanium implants inserted in the femurs of the thirty two adult rats. The right side is considered as experimental groups and the left side considered as control groups. Autologous platelet rich fibrin matrix applicated with the right screw implants . The sample divided into four groups, eight rats are sacrificed at four interval 3days, 7days, 2weeks, and 6weeks respectively. Histological, immunohistochemical (PDGF-A&IGF-1), and radio graphical were studied for each interval. Results: Histological examination showed the acceleration of bone formation and more rapid healing process in the screw implant with PRFM than in the control implant. Radio graphical examinations showed that the process of osseointegration started after 2weeks and complete radio opacity around the titanium implant after 6weeks. Immunohistochemical findings revealed high positive expression for IGF and PDGF in experimental implant in comparison to control one. Conclusion: This study was illustrated that PRFM material was osseo inductive material that enhances the osseointegration process in titanium implant site in comparison to the normal physiological healing process. The results show a positive effect of PRFM and it can be suggested for beneficial use in the practice of dentistry implantation, periodontics, oral surgery since it enhance osseointegration, reduce the period of patient suffering and the incidence of post implant complications.

The Effect of Platelet-Rich Fibrin Matrix on Rotator Cuff Healing in a Rat Model (SS-62)

Healing following a rotator cuff repair occurs via fibrous scar tissue formation that is structurally and biomechanically different from native tissue. Failure to recapitulate the normal morphology of the tendon-bone enthesis has been theorized to contribute to structural failure of repairs. Platelets have long been shown to play an instrumental role in the normal healing response via the local secretion of growth factors and recruitment of reparative cells. The use of autologous platelet-rich fibrin matrix (PRFM) provides a sustained vehicle of growth factor delivery to augment tendon-bone healing post-surgical repair.

Induction of Dermal Collagenesis, Angiogenesis, and Adipogenesis in Human Skin by Injection of Platelet-Rich Fibrin Matrix

To evaluate the histological changes induced in human skin by injection of autologous platelet-rich fibrin matrix (PRFM). Four healthy adult volunteers were included in the study. Platelet-rich fibrin matrix was prepared from 9 mL of autologous blood using a proprietary system (Selphyl; Aesthetic Factors, Wayne, New Jersey) and injected into the deep dermis and immediate subdermis of the upper arms of subjects. Full-thickness skin biopsy specimens were taken from the treated areas over a 10-week period, and the specimens were processed for histological evaluation. Findings from histological examination supported the clinical observation of soft-tissue augmentation. As early as 7 days after treatment, activated fibroblasts and new collagen deposition were noted and continued to be evident throughout the course of the study. Development of new blood vessels was noted by 19 days; also at this time, intradermal collections of adipocytes and stimulation of subdermal adipocytes were noted. These findings became more pronounced over the duration of the study, although the fibroblastic response became much less pronounced. No abnormal mitotic figures were observed at any point, and a very mild chronic inflammatory response was noted only at the earliest time points of the study. Injection of PRFM into the deep dermis and subdermis of the skin stimulates a number of cellular changes that can be harnessed for use. Coupled with prior in vitro and in vivo studies, we now have a much clearer picture of the cellular effects of PRFM and its potential uses in facial plastic surgery. Further work is planned to more clearly elucidate the potential role of PRFM in aesthetic and reconstructive surgery. clinicaltrials.gov Identifier: NCT00956020

Induction of Dermal Collagenesis, Angiogenesis, and Adipogenesis in Human Skin by Injection of Platelet-Rich Fibrin Matrix

To evaluate the histological changes induced in human skin by injection of autologous platelet-rich fibrin matrix (PRFM). Four healthy adult volunteers were included in the study. Platelet-rich fibrin matrix was prepared from 9 mL of autologous blood using a proprietary system (Selphyl; Aesthetic Factors, Wayne, New Jersey) and injected into the deep dermis and immediate subdermis of the upper arms of subjects. Full-thickness skin biopsy specimens were taken from the treated areas over a 10-week period, and the specimens were processed for histological evaluation. Findings from histological examination supported the clinical observation of soft-tissue augmentation. As early as 7 days after treatment, activated fibroblasts and new collagen deposition were noted and continued to be evident throughout the course of the study. Development of new blood vessels was noted by 19 days; also at this time, intradermal collections of adipocytes and stimulation of subdermal adipocytes were noted. These findings became more pronounced over the duration of the study, although the fibroblastic response became much less pronounced. No abnormal mitotic figures were observed at any point, and a very mild chronic inflammatory response was noted only at the earliest time points of the study. Injection of PRFM into the deep dermis and subdermis of the skin stimulates a number of cellular changes that can be harnessed for use. Coupled with prior in vitro and in vivo studies, we now have a much clearer picture of the cellular effects of PRFM and its potential uses in facial plastic surgery. Further work is planned to more clearly elucidate the potential role of PRFM in aesthetic and reconstructive surgery.