Autologous Platelet-rich Plasma Gel Research Articles

Efficacy and Safety of Autologous Platelet-Rich Plasma Gel in the Treatment of Chronic Skin Ulcerations

Background: Chronic wounds, which are persistent disruptions in skin integrity, represent a significant global health challenge. Various types of ulcers, including venous, arterial, diabetic, pressure, and traumatic ulcers, contribute to personal, professional, and societal burdens. Autologous platelet-rich plasma (PRP) has emerged as a promising therapeutic option by leveraging the growth factors in platelets for tissue regeneration. Methods: This prospective study, conducted from December 2021 to December 2023, enrolled 10 patients with chronic ulcers. The PRP gel was prepared through a systematic process that included blood collection, centrifugation, and activation. Results: The study included 8 males and 2 females, with an average age of 48.8 years. Ulcer etiologies encompassed diabetic foot ulcers, arterial ulcers, and venous ulcers, among others. The initial average surface area of the ulcers was 18.7 cm2. Complete healing was observed in a case of Buerger's disease, while very good healing was achieved in one diabetic foot ulcer, one venous ulcer, and another case of Buerger's disease. Moderate healing was noted in five cases of arterial ulcers, and poor healing was observed in one case of prolidase deficiency. The average surface area post-treatment for all patients was reduced to 8.05 cm2, with no reported pain or adverse effects. Conclusions: Platelet-rich plasma gel emerges as a promising alternative to traditional treatments, potentially lessening the overall impact on healthcare resources and enhancing the quality of life for individuals with chronic ulcers.

Effectiveness of APG and Honey Gauze in Pressure Injury of Elderly: A Randomized Control Trial.

This study was designed to evaluate the efficiency of the combination of autologous platelet-rich plasma gel (APG) and Manuka honey gauze in the treatment of Stages 3-4 pressure injury of older adults. Patients were divided into four groups: Manuka honey gauze and APG (M + A), Manuka honey gauze (M), APG (A), and a control group (C). Different treatments were given, then wound bed coverage with granulation tissue, wound size reduction, and Pressure Ulcer Scale for Healing (PUSH) score were examined. Paraffin-embedded sections of wound tissues were analyzed and wound swab cultures were assessed. Kruskal-Wallis test and Mann-Whitney U test were performed in statistical analysis at a 5% significance level. A total of 42 patients were accepted. Significant increase of wound bed coverage with granulation tissue (51.24%, P = .004, Kruskal-Wallis test) and decrease of PUSH score (-5) were observed in the M + A group at the end of the observation (P = .032, Mann-Whitney U test). The hematoxylin-eosin staining of wound tissues showed that typical squamous epithelium was seen in wound bed of patient in M + A group. Manuka honey gauze and APG were proved to be superior treatments for pressure injury of old patient. Increase of granulation tissue coverage, reduction of PUSH score, and improved growth of epithelium were observed in M + A group. There was no side-effect, and the treatment would not cause infection.

The Potential of Autologous Platelet-Rich Plasma Gel for Diabetic Foot Ulcer Care Among Older Adults: A Systematic Review and Meta-Analysis.

Poorly controlled diabetes mellitus can lead to the development of diabetic foot ulcers (DFU), which is a frequent complication in patients. However, several diabetes management guidelines for older adults do not mention the occurrence of DFUs. Nowadays, Autologous Platelet-Rich Gel (APG) is being used for treating diabetic ulcers. APG is an innovative platelet-derived product with many advantages, such as being low-cost, easy to produce, and readily available materials. Additionally, it does not lead to any rejection reaction. This study aims to assess the safety and efficacy of APG as a novel treatment of DFU compared with standard treatment in older adult patients. Randomized Controlled Trials (RCTs) were searched using PubMed, Cochrane, Google Scholar, Wiley, and PlosOne. The keywords have been arranged using the Boolean operator, including autologous platelet-rich gel, DFU, and elderly. The data was screened by inclusion and exclusion criteria. The final inclusion study was analyzed and synthesized by tabulation, clusterization, contextual and thematic approach, and assessed for risk of bias using ROB 2.0. Meta-analysis was conducted by using Review Manager 5.4 and the Mantel Haenszel method. Eight RCTs with 598 patients were eligible for the present analysis. Compared with standard care/conventional treatment, APG could significantly improve the healing wound in patients with diabetic foot ulcers (Relative risk (RR) 1.32, 95% confidence interval (CI) 1.22-1.57, p < 0.0001), shortened the healing time (Mean difference [MD] -16.97 days (95% CI: -32.64 to -1.29; p < 0.00001), shortened the length of hospital stay (MD= -20.11, 95% CI: -38.02, -2.20; p = 0.03), and amputation rate (MD= 0.36, 95% CI: 0.16, 0.84; p = 0.02). APG treatment can better treat DFU in terms of duration of healing, wound healing, length of hospital stay, and amputation prevention than the standard treatment.

The Therapeutic Effects of Autologous Platelet-Rich Plasma Gel on Cutaneous Wound Healing in Rescued Horses

This study explored the effect of platelet-rich plasma gel on skin wound healing in rescued horses. A total of twenty horses were used and allocated into two groups: PRP-treated Group A (n=10) and ASD-treated Group B (n=10). Group A animals were treated with autologous PRP gel, while group B animals were treated with sterile saline. A full-thickness (1.5 mm2) skin wounds were selected in each horse. Histopathological examination of wound tissue in horses was performed on days 8, 40, and 60. Wound epithelialization was assessed by HE staining, and collagen re-establishment was assessed by Masson’s trichrome staining. The CAT activity and MDA concentration were assessed in blood samples on days 8, 40, and 60. All data were subjected to statistical analysis. We observed a highly significant increase (P&lt;0.01) in re-epithelization at days 40 to 60 in the PRP wounds compared to the ASD wounds. Collagen was well organized (P&lt;0.01) in the PRP wounds compared with the ASD wounds at day 40 to day 60. MDA concentration was significantly decreased from day 40 to day 60 (P&lt;0.05) in the PRP wounds than the ASD wounds. CAT activity showed no difference (P&gt;0.05) between PRP wounds and ASD wounds. In conclusion, compared to ASD wounds, PRP wounds promoted cutaneous wound healing in horses by suppressing oxidative stress levels, accelerating wound epithelialization, and generating organized tissue, interlocking collagen bundles of dermal collagen. However, ultrasonographical assessment level study is needed to further investigate the effect of PRP gel on skin wound healing in rescued horses.&#x0D; Keywords: Horses, Oxidative stress, Platelet-Rich Plasma, Sterile saline, Skin Wound Healing.

Platelet-rich plasma-loaded bioactive chitosan@sodium alginate@gelatin shell-core fibrous hydrogels with enhanced sustained release of growth factors for diabetic foot ulcer healing

The ability of autologous platelet-rich plasma (PRP) gel to promote rapid wound healing without immunological rejection has opened new avenues for the treatment of diabetic foot wounds. However, PRP gel still suffers from the quick release of growth factors (GFs) and requires frequent administration, thus resulting in decreased wound healing efficiency, higher cost as well as greater pain and suffering for the patients. In this study, the flow-assisted dynamic physical cross-linked coaxial microfluidic three-dimensional (3D) bio-printing technology, combined with the calcium ion chemical dual cross-linking method was developed to design PRP-loaded bioactive multi-layer shell-core fibrous hydrogels. The prepared hydrogels exhibited outstanding water absorption-retention capacity, good biocompatibility as well as a broad-spectrum antibacterial effect. Compared with clinical PRP gel, these bioactive fibrous hydrogels displayed a sustained release of GFs, reducing the administration frequency by 33 % availably during the wound treatment, but more prominent therapeutic effects such as effective reduced inflammation, in addition to promoting the growth of granulation tissue and angiogenesis, the formation of high-density hair follicles, and the generation of regular ordered and high-density collagen fiber network, which suggested great promise as exceptional candidates for treatment of diabetic foot ulcer in clinical settings.

Can platelet-rich plasma coating improve polypropylene mesh integration? An immunohistochemical analysis in rabbits.

ABSTRACTPurpose:Despite high success rates in the treatment of urinary incontinence, complications related to the use of polypropylene (PP) meshes are still a concern, especially in vaginal prolapses surgeries. The objective of this study was to assess the effect of autologous platelet-rich plasma (PRP) coating on the integration of PP meshes implanted in the vaginal submucosa of rabbits.Materials and Methods:Thirty adult New Zealand rabbits were randomly divided into two groups (n=15): PP, implanted with conventional PP meshes; and PRP, implanted with autologous PRP coated PP meshes. Animals in both groups (n=5) were euthanized at 7, 30 and 90 days postoperatively, the vaginas extracted and sent to immunohistochemical analysis for the assessment of the pro-inflammatory agent TNF-α, anti-inflammatory agents TGF-β and IL-13, collagen metabolism marker MMP-2, and angiogenesis marker CD-31. AxioVision™ image analysis was used for the calculation of the immunoreactive area and density. Statistical analysis was performed with ANOVA followed by Tukey test (p <0.05).Results:Animals in the PRP group showed significantly increased expression of the angiogenesis agent CD-31 at all experimental times when compared to the PP group (p <0.0001). However, no differences concerning the expression of the other markers were observed between the groups.Conclusion:The addition of autologous PRP gel to PP meshes can be simply and safely achieved and seems to have a positive effect on implantation site angiogenesis. Further investigations are required to ascertain PPR coated meshes clinical efficacy in prolapses and stress urinary incontinence surgeries.

Clinical effects of autologous platelet rich plasma gel combined with vacuum sealing drainage techno-logy in repairing refractory wounds

Objective: To investigate the clinical effects of autologous platelet rich plasma (PRP) gel in combination with vacuum sealing drainage (VSD) technology in repairing refractory wounds. Methods: From March 2011 to January 2015, 44 patients with refractory wounds meeting the inclusion criteria were recruited into VSD alone group, who were admitted to the Department of Burns and Plastic Surgery of the Yidu Central Hospital of Weifang and received intermittent VSD treatment. From February 2015 to September 2019, 43 patients with refractory wounds meeting the inclusion criteria were recruited into PRP+ VSD group, who were admitted to the same unit as above-mentioned and received PRP combined with intermittent VSD treatment. The retrospective cohort study was conducted. There were 24 males and 20 females with age of (37.5±2.2) years in VSD alone group, and there were 25 males and 18 females with age of (37.0±2.5) years in PRP+ VSD group. The wound exudate of patients in the two groups before and 7 and 14 d after the first treatment were collected for bacterial culture, and the positive rate of bacterial culture was calculated. The wound healing of patients in the two groups was observed on 7, 14, and 21 d after the first treatment, and the wound healing rate was calculated. The complete wound healing time of patients in the two groups was recorded. The degree of wound pain of patients in the two groups was evaluated by the Visual Analog Scale (VAS) before and 14 d after the first treatment. The scar hyperplasia of patients in the two groups was evaluated by the Vancouver Scar Scale (VSS) in 1 and 2 months after the wound healed completely. The occurrence of adverse reactions of patients in the two groups during the whole period of treatment was observed and the incidence of adverse reactions was calculated. Data were statistically analyzed with analysis of variance for repeated measurement, chi-square test, paired t test, and Bonferroni correction. Results: The positive rates of bacterial culture in wound exudate of patients in PRP+ VSD on 7 and 14 d after the first treatment were 37.2% (16/43) and 11.6% (5/43), which were significantly lower than 56.8% (25/44) and 29.5% (13/44) in VSD alone group, χ(2)=4.212, 4.255, P<0.05. The wound healing rates of patients in PRP+ VSD group on 7 and 14, and 21 d after the first treatment were respectively (58±14)%, (70±13)%, (89±12)%, which were significantly higher than (41±11)%, (60±11)%, (74±12)% in VSD alone group, t=6.323, 3.820, 5.751, P<0.01. The complete wound healing time of patients in PRP+ VSD group was (30±6) d, which was significantly shorter than (61±8) d in VSD alone group, t=20.890, P<0.05. The VAS score of patients in PRP+ VSD group was significantly lower than that in VSD alone group on 14 d after the first treatment (t=13.904, P<0.01). The VSS score of patients in PRP+ VSD group was significantly lower than that in VSD alone group in 1 and 2 months after the wound healed completely (t=3.307, 3.637, P<0.01). The incidence of adverse reactions of patients in PRP+ VSD group during the whole period of treatment was 7.0% (3/43), which was significantly lower than 22.7% (10/44) in VSD alone group, χ(2)=4.245, P<0.05. Conclusions: Autologous PRP gel combined with VSD technology in repairing refractory wounds not only has good bacteriostatic effect, but also can increase wound healing rate, shorten wound healing time, alleviate wound pain, reduce scar hyperplasia, with less adverse reaction, which is worthy of promotion.

Efficacy of autologous platelet-rich plasma gel in the treatment of refractory pressure injuries and its effect on wound healing time and patient quality of life

OBJECTIVES:To evaluate the efficacy of autologous platelet-rich plasma (PRP) gel in the treatment of refractory pressure injuries and its effect on wound healing time and quality of life of patients.METHODS:A random number table method was used to group 102 patients with refractory pressure injuries into either a control group (CG) (51 cases) receiving negative pressure wound therapy (NPWT) or a study group (SG) (51 cases) receiving NPWT+PRP gel.RESULTS:The total efficacy rate in the SG (92.16%) was higher than that in the CG (76.47%) (p<0.05). The SG exhibited lower visual analog scale (VAS) scores and pressure ulcer scale for healing (PUSH) scores, smaller wound sizes and depths, and shorter wound healing times than the CG after 21 days of treatment (p<0.05). After 6 months of treatment, the SG scored higher than the CG on the psychological, physiological, social functions, and daily activity domains on the World Health Organization Quality of Life (WHOQOL-BREF) scale (p<0.05). The incidence of postoperative complications in the SG (13.73%) was not significantly different from that of the CG (7.84%) (p>0.05).CONCLUSION:In the treatment of refractory pressure injuries, PRP gel can accelerate wound healing, reduce wound pain, shorten the treatment cycle, regulate tissue inhibitor matrix metalloproteinase-1 (TIMP-1) and matrix metalloproteinase-9 (MMP-9) levels and the expression of specific proteins in granulation tissue, reduce the levels of the inflammatory factors interleukin-1β (IL-1β), IL-8, and tumor necrosis factor-α (TNF-α), and improve the quality of life of patients without increasing complications.

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.

Effectiveness of autologous platelet-rich plasma gel in the treatment of hard-to-heal leg ulcers: a randomised control trial

Objective: Regenerative medicine products such as autologous platelet-rich plasma (autologous PRP) gel may speed up the process of healing. Clinical studies show promising results in the treatment ...

Efficacy of autologous platelet rich plasma gel in soft and hard tissue healing after surgical extraction of impacted mandibular third molar - A prospective study

ObjectivesThis prospective study was designed to assess the efficacy of autologous PRP gel in healing of extraction socket after surgical extraction of impacted mandibular third molar. MethodsA total of 100 patients necessitating treatment were randomly allocated in two groups; experimental and control. In experimental group, PRP gel was placed in the extraction socket after extraction, whereas in control group the similar procedure was carried out without application of PRP gel. The outcome variables were pain, swelling, and maximum mouth opening, which were assessed on 1st, 3rd, 5th, 7th and 14th day following extraction. Socket healing was analyzed radiographically by allocating scores for overall density and trabecular pattern on 4th, 10th and 16th week postoperatively. ResultsResults showed significant lower pain scores, reduced facial swelling and improved interincisal opening in experimental group postoperatively when compared to control group. The bone density and trabeculae pattern in both groups didnot show any difference at 4th week. However, highly significant difference (P value < 0.005) was observed between both groups radiographically at 10th and 16th weeks following extraction. ConclusionsThe present study concludes that the use of simple, cost- effective method of autologous PRP gel may be beneficial to enhance the wound healing process and promotes bone regeneration.

Effectiveness of autologous platelet-rich plasma gel in the treatment of hard-to-heal leg ulcers: a randomised control trial.

Regenerative medicine products such as autologous platelet-rich plasma (autologous PRP) gel may speed up the process of healing. Clinical studies show promising results in the treatment of diabetic foot ulcers (DFUs), however there is lack of scientific evidence of autologous PRP effectiveness in treating leg ulcers of other aetiology. This study evaluates the effectiveness of autologous PRP gel in the treatment of hard-to-heal leg ulcers compared with existing conventional treatment. A prospective, randomised controlled, open-labelled clinical trial was carried out between 2014 and 2018. An eight-week study protocol was chosen or until 100% wound re-epithelialisation was observed. Wound size reduction, granulation tissue formation, microbiological wound bed changes and safety were evaluated. A total of 69 patients (35 in the autologous PRP group and 34 in the control group) were included in the study; 25.71% of the autologous PRP group and 17.64% of control group had ulcers completely re-epithelialised (p>0.05). Wound size reduction in the autologous PRP group was 52.35% and 33.36% in the control group (p=0.003). The autologous PRP group showed superiority over conventional treatment in wound bed coverage with granulation (p=0.001). However, more frequent wound contamination was observed at the end of treatment in the autologous PRP group (p=0.024). No severe adverse events were noted during the study. Both treatment methods were considered equally safe. Topical application of autologous PRP gel in leg ulcers of various aetiology show beneficial results in wound size reduction and induces the granulation tissue formation. However, it is associated with more frequent microbiological wound contamination.

The use of autologous platelet-rich plasma gel increases wound healing and reduces scar development in split-thickness skin graft donor sites

The treatment of donor sites after split-thickness skin grafting (STSG) is a routine operation step, and complications at the donor site due to improper operation and care are unwelcome. This study evaluates whether the use of platelet-rich plasma (PRP) applied at the STSG area promotes wound healing and improves scar development. Clinical data of 30 patients who underwent STSG operations between January 2016 and January 2017 for various reasons were retrospectively analyzed. These 30 patients received two treatments and the data were summed up in two groups: the PRP group, which was the study group, included patients who received traditional petrolatum gauze dressing with PRP gel at the donor sites. The petrolatum gauze group, which was the control group, received only petrolatum gauze care without PRP gel. The time and frequency of dressing change were comparable between the two groups, and the mean wound healing times in the PRP group and petrolatum gauze group were 13.89 ± 4.65 and 17.73 ± 5.06 days, respectively, and the difference was statistically significant (p < 0.05). In addition, the total Vancouver scar scale (VSS) scores of the PRP group at 4, 12 and 52 weeks were 6.41 ± 0.77, 4.42 ± 0.43 and 2.41 ± 0.39, respectively, which were statistically significantly lower (p < 0.05) than those of the control group at 7.67 ± 0.64, 6.28 ± 0.62 and 4.29 ± 0.64, respectively. The use of PRP gel can promote wound healing, relieve scar development and alleviate pain at the donor site after STSG.

Clinical effects of autologous platelet-rich plasma gel in the repair of chronic wounds

Objective: To explore the clinical application effects of autologous platelet-rich plasma gel in the repair of various chronic wounds. Methods: From January 2015 to January 2018, 76 patients with chronic wounds were admitted to our unit, with 39 men and 37 women, aged 28 to 75 (52±6) years. Before the operation, areas of wounds ranged from 2.0 cm×0.5 cm to 17.0 cm×5.0 cm, depths of wounds ranged from 1 to 6 cm, areas of wounds substrate ranged from 3 cm×3 cm to 17 cm×8 cm, and volumes of deep cavities ranged from 7 to 55 mL. All patients received operation 2 to 7 days after admission. Autologous platelet of 220-250 mL was collected from each patient by single extraction to make platelet-rich plasma of 10-50 mL. The cavity was filled completely by injection of platelet-rich plasma gel for 1-3 times. Wounds were sutured directly or covered by local flaps or other materials according to the conditions of wounds, and the unclosed wounds in primary stage were treated by continuous vacuum sealing drainage (VSD). Ultrasound, CT, or magnetic resonance imaging was performed to detect the healing of cavity after the operation. The healing of wound and repair of cavity after the operation and during follow-up were observed. Results: Wounds in 39 patients were closed directly after primary operation. Among them, wounds of 36 patients were healed completely, and wounds of the other 3 patients were healed completely after second debridement and topical filling of platelet-rich plasma gel. The cavities in 35 patients were filled with granulation tissue after treatment of platelet-rich plasma gel for 1-3 times combined with VSD, and the wounds were healed after skin grafting or flap transplantation. The treatment of wounds discontinued in the other 2 patients after treatment of platelet-rich plasma gel for once. Postoperative follow-up was lost in 7 patients. During follow-up of 2 and/or 4 months after the primary operation, wounds were healed well with no recurrence, and cavities were filled with fibrous tissue. Conclusions: Autologous platelet-rich plasma gel has advantages in treating chronic wounds, including a large amount by single extraction, flexible use mode, ability to fully fill the complex cavity, high surgical safety, and mild secondary injury. It's a new choice for repair of chronic wounds in clinic.

Biostimulation of venous chronic ulcers with platelet-rich plasma gel and biocompatible membranes of chitosan and alginate: A pilot study

Abstract Venous ulcers are a common disease caused by circulatory insufficiency, having as characteristics slow healing and therefore a difficult treatment. Consequently, this disease has a high impact at personal, professional and social levels, representing large costs for both patients and healthcare system. The aim of the present pilot study was to evaluate the effectiveness of an alternative treatment for this specific type of wound, based on the use of autologous platelet-rich plasma gel (PRP) combined with biocompatible porous membranes produced with the polysaccharides chitosan (C) and alginate (A). The applicability, security and healing efficacy of this treatment was evaluated in four patients suffering from venous ulcers with an at least 6-month of evolution that did not heal after conventional treatments. The clinical evolution analysis during the treatment was performed by periodic measurement of the lesions area for an average of 5.4 months. The results attained showed that the use of this treatment led to completed reduction in the ulcers area as well as to pain decrease. Hence, the combination between autologous PRP gel and chitosan-alginate (CA) porous membranes could be a useful alternative to treat chronic skin ulcers in humans.

Arthroscopic knotless tape bridging with autologous platelet-rich fibrin gel augmentation: functional and structural results

ABSTRACTBackground: Rotator cuff repairs remain a source of iterative ruptures and disappointing functional results. In this goal, autologous platelet-rich plasma (PRP) has been used to improve tendon healing. This prospective study assessed the contribution of fully autologous gel concentrates (platelet concentrates and thrombin) on healing after cuff repair.Methods: A consecutive series of 69 patients who underwent primary arthroscopic knotless tape bridging primary cuff repair of supraspinatus tear were evaluated. Two groups were created (A: n = 32, B: n = 37). Autologous PRP gel, obtained preoperatively by PRP mixed with autologous thrombin extracted from platelet-poor plasma, was injected at bone-tendon interface at end of repair in group A. Gel structure avoided evacuation of concentrates with irrigation liquid. Constant, QuickDash and Visual Analogue Scale (VAS) scores were assessed pre-operatively and then successively post-operatively. Healing was assessed by 24-month control MRI according to Sugaya’s classification. Sugaya 3, 4, and 5 were considered as iterative ruptures.Results: Average age was 56 years (±7.8). Mean follow-up was similar: 28.6 months (±3.3) vs 32.4 months (±9.4). Mean preoperative Constant was similar: 53.4 (±3.4) vs 54.6 (±5.4). Group A patients received 3.5 ml (±1.5 ml) of autologous PRP gel. No specific complication of injection was found. We observed higher trend in favour of PRP without significativity: Constant 86.7 (±11.1) vs 81.6 (±14.4), p = 0.11; VAS: 0.6 (±0.3) vs 1.1 (±0.9), p = 0.13; Forward flexion: 139.5° (±14.4°) vs 137.7° (± 16.5°), p = 0.63; Strength score: 17.6 vs 14.8, p = 0.66; QuickDash: 6.2 (±5.3) vs 8.2 (±6.9), p = 0.32 . On MRI, 90% (n = 3) of repairs were healed in group A versus 86% (n = 5) in group B.Conclusion: In this preliminary study, the group treated with autologous PRP gel showed a trend towards better clinical and radiological results. These results were not significant at the last follow-up. Only significantly higher clinical results were found at 3 months.Study design: Therapeutic prospective comparative cohort study; Level of evidence III.

Production cost of autologous platelet rich plasma gel.

Objective:to estimate the direct cost of producing autologous platelet rich plasma gel.Method:an economic, prospective, longitudinal study with direct cost estimation, from the perspective of the Unified Health System, conducted in a university hospital in the state of Rio de Janeiro, over a period of 12 weeks. It was approved by the Ethics Committee of the School of Medicine. Direct observation of 18 participants was conducted. Material and human resources categories were analyzed for production costs.Results:the cost of producing platelet rich plasma gel was US $4.88 per session, for a total of US $5.16, when the material resources per unit were considered in the Unified Health System. The time to complete the procedure was approximately 22 minutes.Conclusion:the production of platelet rich plasma gel involves low cost material resources for both blood collection and preparation, enabling universal access to treatment. The procedure requires trained staff in an appropriate location; it is a safe and inexpensive technology.

Platelet-rich plasma in lower limb ulcers

Objective The aim of this study was to evaluate the role of platelet-rich plasma gel in patient with lower limb ulcers: diabetic and varicose ulcers. Background Diabetic foot ulcer is a major complication of diabetes mellitus. Platelet-rich plasma (PRP) is used for managing diabetic foot ulcers. PRP contains alpha- granules that release growth factors on activation such as platelet-derived growth factor (PDGF) which are important for wound healing by being angiogenic and helping stem cell differentiation and maturation. Patients and methods The study included 30 patients with chronic ulcers who were selected from vascular surgery department of Menoufia University Hospitals in the duration between February 2016 and March 2017. Patients were categorized into group I (15 patients with diabetic ulcers) and group II (15 patients with varicose ulcers). PRP gel was applied every 2 weeks for a maximum of 6 weeks. PRP was evaluated for concentration of PDGF-AB before and after activation by immunoassay. Results There was significant increase in PRP platelets count and PDGF-AB concentration after activation (P Conclusion Autologous PRP gel is an efficient and a safe source of growth factors for managing lower limb ulcers.

Evaluation of Three Methods of Platelet-Rich Plasma for Treatment of Equine Distal Limb Skin Wounds

Wounds localized on the distal limbs in horses are difficulty healing. No studies have been conducted to evaluate homologous platelet-rich plasma (PRP) in horses. The aim of this study was to evaluate the effect upon applying autologous PRP, homologous PRP, and autologous PRP gel on the wound healing process of wounds on the distal limb of horses. To study a possible correlation between the platelet count and wound healing time, four skin wounds of 4 cm2 were surgically created on the dorsolateral aspect of the third metacarpus in eight healthy adult horses. Each skin wound was randomly treated according to the established treatment groups (G): GI, treated with autologous PRP injection on the wound edges; GII treated topically with autologous PRP gel; and GIII homologous PRP injection on the wound edges and control group treated with saline solution injected on the wound edges. The animals were monitored every fifteen days throughout the wound healing process. The wound size was determined using a tape measure. Skin biopsies were obtained on the 15th and 30th day after the first PRP treatment. Autologous PRP gel treatment reduced the healing time in 15 days compared to the wounds of the control group. Histologically, GII presented a higher frequency of mild inflammation and mild to moderate neovascularization of biopsies 1 and 2. Platelet-rich plasma in gel form showed the best result on wound healing of the distal limb of horses in both clinical and histopathological evaluations. The homologous PRP is recommended for the recovery of animals with compromised hemodynamic conditions.

Effect of Autologous Fibrin Gel and Platelet Rich Plasma Activated by Ozone versus Those Activated by Calcium Chloride on Wound Healing and Prevention of Infection in High Risk Cesarean Sections : Randomized Controlled Study

Background: Cesarean delivery, one of the most common major surgical procedures performed worldwide used for 15% of births around the world and it continues to increase in frequency. It is an important contributor to surgical site complications such as infection, hematoma and dehiscence. Platelet Rich Plasma (PRP) is a volume fraction of blood having a high concentration of platelets above the baseline. This product is a rich source of growth factors. PRP can be activated by CaCl2 or medical Ozone. The induction of growth factors found in PRP by ozone can support and potentiate their action. Aim: The purpose of this study is to compare the effect of application of autologous Fibrin Gel and Platelet Rich Plasma (PRP) activated by medical Ozone (Ozonated PRP) versus those activated by CaCl2 on wound healing and prevention of infection in high risk cesarean sections. Design: 90 high risk pregnant females undergoing cesarean section were selected randomly according to inclusion criteria and divided into 3 groups each contains 30 patients. Group Ca received Autologous PRP and Fibrin gel activated by CaCl2 at the wound site. Group O received Autologous PRP and Fibrin gel activated by Medical Ozone at the wound site while group P (control) did not receive any of them. All patients were examined for wound complications and healing progress on day 1, day 7 and day 21 postoperative by visual analogue scale (VAS), REEDA scale and Vancouver Scar System (VSS). Results: the results revealed statistically significance decrease in pain by VAS in group Ozone compared to group P on day 7 and 21. For REEDA also group O showed significant decrease compared to group Calcl on day 1 and 7 while compared to group P was also decreased on day 1, 7 and 21. Group Cacl was significantly decreased compared to group P on day 7 and 21 only. Regarding VSS both group O and group Cacl were significantly decreased compared to group P on all days. Conclusion: this study gives evidence that applying autologous platelet rich plasma (PRP) promote wound healing and when activated by Ozone gives better results and helps prevention of infection in cesarean section of high risk patients.