Platelet-rich Plasma Gel Research Articles

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.

The Effect of Encapsulated Umbilical Cord-derived Mesenchymal Stem Cells in PRPCryogel on Regeneration of Grade-II Burn Wounds

To achieve an efficient approach for burn regeneration, we aimed to investigate the effects of encapsulated human umbilical cord-derived mesenchymal stem cells (hUMSCs) in platelet-rich plasma cryogel (PRPCryogel) on regeneration of grade-II burn wounds in a rat model. MSCs were extracted from the umbilical cord and characterized by flow cytometry. Forty rats were divided into 4 groups including PRPCryogel-MSCs, PRPCryogel, MSCs, and control treatment. After 7, 14, 21, and 28 days post-treatment, the wound sites were photographed and wound samples were taken. H&E staining for wound samples was done to assess re-epithelialization, angiogenesis, and formation of granulated tissue. The gene expression rates of Ang-1 and VEGF growth factors were also determined by qRT-PCR. The higher wound closure rate was seen for the PRPCryogel-MSCs group on day 21 and 28 compared to other groups. Based on H&E results, an ascending rate of re-epithelialization was seen for the PRPCryogel-MSCs group on day 28. The most angiogenesis rate was detected for MSCs and PRPCryogel-MSCs groups on day 14. The qRT-PCR results showed the peak expression rate of Ang-1 in PRPCryogel-MSCs and MSCs groups on day 14. The peak expression rate of VEGF was also seen for PRPCryogel-MSCs and PRPCryogel groups on day 28. The treatment of burn wounds with PRPCryogel-MSCs promoted the wound closure and re-epithelialization rates. It also increased the expression rate of Ang-1 and VEGF genes which is consistent with pathological assessments. In conclusion, combination of MSCs with PRP can be considered as a promising approach for burn healing. Application of different natural substances for wound healing returns to a long period of time ago. Nature has been always generous and among these, mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) are such prominent gifts. MSCs have been well-identified for tissue regeneration which can be derived from bone marrow, umbilical cord, adipose tissue, etc. By differentiation into key cells such as fibroblasts and keratinocytes, contributing in vascularization, re-epithelialization, and collagen synthesis, MSCs accelerate the regeneration of damaged tissue. PRP is another spectacular substance derived from blood which is a rich suspension of platelets, growth factors with pain relieving and antimicrobial effects. We assessed the effects of MSCs which were placed within the PRP gel (PRPCryogel) on healing of grade-II burn wounds. Results showed that PRPCryogel-MSCs promote burn healing by increasing the rate of wound closure, angiogenesis, and re-epithelialization compared to other groups. This verifies the impressive effects of MSCs with PRP when combined together for burn treatment. Finally, this method can be also examined on regeneration of grade-III burn and/or chronic wounds as a future study in this field.

Spinal Reflex Recovery after Dorsal Rhizotomy and Repair with Platelet-Rich Plasma (PRP) Gel Combined with Bioengineered Human Embryonic Stem Cells (hESCs).

Dorsal root rhizotomy (DRZ) is currently considered an untreatable injury, resulting in the loss of sensitive function and usually leading to neuropathic pain. In this context, we recently proposed a new surgical approach to treat DRZ that uses platelet-rich plasma (PRP) gel to restore the spinal reflex. Success was correlated with the reentry of primary afferents into the spinal cord. Here, aiming to enhance previous results, cell therapy with bioengineered human embryonic stem cells (hESCs) to overexpress fibroblast growth factor 2 (FGF2) was combined with PRP. For these experiments, adult female rats were submitted to a unilateral rhizotomy of the lumbar spinal dorsal roots, which was followed by root repair with PRP gel with or without bioengineered hESCs. One week after DRZ, the spinal cords were processed to evaluate changes in the glial response (GFAP and Iba-1) and excitatory synaptic circuits (VGLUT1) by immunofluorescence. Eight weeks postsurgery, the lumbar intumescences were processed for analysis of the repaired microenvironment by transmission electron microscopy. Spinal reflex recovery was evaluated by the electronic Von Frey method for eight weeks. The transcript levels for human FGF2 were over 37-fold higher in the induced hESCs than in the noninduced and the wildtype counterparts. Altogether, the results indicate that the combination of hESCs with PRP gel promoted substantial and prominent axonal regeneration processes after DRZ. Thus, the repair of dorsal roots, if done appropriately, may be considered an approach to regain sensory-motor function after dorsal root axotomy.

Rheological Properties and Growth Factors Content of Platelet-Rich Plasma: Relevance in Veterinary Biomedical Treatments.

Platelet-rich plasma (PRP) is a nontransfusional hemocomponent, considered as a powerful concentrate of growth factors (GFs) therapeutically used to stimulate tissue regeneration. The use of autologous PRP, as the patient’s own biological material, for therapeutic purposes represents a safe and effective alternative to conventional treatments in both human and veterinary medicine. The aim of this study was the characterization of canine PRP from rheological and biological points of view. Thus, a characterization of the viscoelastic properties of the PRP systems was performed in order to clarify the influence of different calcium concentrations, in the presence of autologous thrombin-rich solution, on the PRP gels’ mechanical properties, from which the applicability of these systems in biomedical treatments is strongly dependent. Then, an evaluation of the content of GFs in PRP, activated or not with thrombin, and stored at different temperatures (37 °C and −20 °C) was performed over time, outlining, for the first time, the importance of the effect of physiological temperature (37 °C) on the production of GFs. A clinical case study conducted in a dog with a complete rupture of the common calcaneal tendon (Achilles tendon) confirmed the relevance of this hemocomponent in the daily veterinary clinical activity and the potential translational value for human health.

Effect of rat bone marrow stromal stem cells overexpressing platelet-derived growth factor and bone morphogenic protein into platelet-rich plasma gels on osteogenic differentiation

The aim of this study was to improve osteoblast function by incorporating rat bone marrow stromal stem cells (rBMSCs) overexpressing platelet-derived growth factor (PDGF-BB) and bone morphogenic protein (BMP-2) into platelet-rich plasma (PRP) gels. rBMSCs were isolated, cultured, and identified. The rBMSCs were subsequently co-transfected with two recombinant adenoviruses delivering PDGF-BB-GFP and BMP-2-GFP. PDGF-BB and BMP-2 expression levels in transduced BMSCs were detected, and a post-transfection analysis of the osteogenic differentiation trend of rBMSCs was performed. Autologous PRP gels were constructed and optimized, and the levels of growth factor in PRP were detected. The optimal growth conditions of the genetically-modified rBMSCs in the scaffolds were established, and the effects of tissue engineering materials and PRP gel construction on the osteogenic differentiation of rBMSCs were assessed. The results revealed that high-purity rBMSCs were obtained, and high levels of BMP-2 and PDGF-BB were secreted by the transduced cells. Furthermore, PRP promoted the proliferation and osteogenic differentiation of rBMSCs overexpressing PDGF-BB and BMP-2. Collectively, the results of the present study revealed that genetically modified rBMSCs incorporated into PRP gels enhanced osteogenic differentiation.

Platelet-Rich Plasma Does Not Inhibit Inflammation or Promote Regeneration in Human Osteoarthritic Chondrocytes In Vitro Despite Increased Proliferation.

ObjectiveThe aims of the study were to assess the anti-inflammatory properties of platelet-rich plasma (PRP) and investigate its regenerative potential in osteoarthritic (OA) human chondrocytes. We hypothesized that PRP can modulate the inflammatory response and stimulate cartilage regeneration.DesignPrimary human chondrocytes from OA knees were treated with manually prepared PRP, after which cell migration and proliferation were assessed. Next, tumor necrosis factor-α–stimulated chondrocytes were treated with a range of concentrations of PRP. Expression of genes involved in inflammation and chondrogenesis was determined by real-time polymerase chain reaction. In addition, chondrocytes were cultured in PRP gels and fibrin gels consisting of increasing concentrations of PRP. The production of cartilage extracellular matrix (ECM) was assessed. Deposition and release of glycosaminoglycans (GAG) and collagen was quantitatively determined and visualized by (immuno)histochemistry. Proliferation was assessed by quantitative measurement of DNA.ResultsBoth migration and the inflammatory response were altered by PRP, while proliferation was stimulated. Expression of chondrogenic markers COL2A1 and ACAN was downregulated by PRP, independent of PRP concentration. Chondrocytes cultured in PRP gel for 28 days proliferated significantly more when compared with chondrocytes cultured in fibrin gels. This effect was dose dependent. Significantly less GAGs and collagen were produced by chondrocytes cultured in PRP gels when compared with fibrin gels. This was qualitatively confirmed by histology.ConclusionsPRP stimulated chondrocyte proliferation, but not migration. Also, production of cartilage ECM was strongly downregulated by PRP. Furthermore, PRP did not act anti-inflammatory on chondrocytes in an in vitro inflammation model.

Application of "diamond concept" in treatment of femoral shaft fractures nonunion after intramedullary fixation

To investigate the effectiveness of the treatment under the guidance of "diamond concept" for femoral shaft fractures nonunion after intramedullary fixation. Between January 2014 and December 2016, 21 cases of femoral shaft fractures nonunion after intramedullary fixation were treated with auxiliary plate fixation combined with autogenous iliac graft, and autologous bone marrow concentrate and platelet-rich plasma (PRP) gel under the guidance of the "diamond concept". There were 13 males and 8 females, with an average age of 32.5 years (range, 17-48 years). All fractures were closed femoral shaft fractures. Four patients underwent internal fixation with plate and resulted in nonunion, then they were fixed with intramedullary nails, but did not heal either. The rest 17 patients were fixed with intramedullary nailing. Fracture nonunion classification: 4 cases of hypertrophic nonunion, 17 cases of atrophic nonunion; the length of bone defect was 1-3 mm; the duration from the last treatment to the current treatment was 10-23 months (mean, 14.3 months). The operation time, intraoperative blood loss, the time between operation and full loading, fracture healing time, and complications were recorded. The visual analogue scale (VAS) score and the imaging system of fracture healing of the extremities (RUST) of patients before operation and at last follow-up were recorded to evaluate the fracture healing; the function of the affected limb was evaluated according to the Schatzker-Lambert efficacy score standard at last follow-up. The operation time was 105-160 minutes, with an average of 125.6 minutes; the intraoperative blood loss was 160-580 mL, with an average of 370.5 mL. All incisions healed by first intention, without vascular or nerve injury. All patients were followed up 22-46 months (mean, 26.5 months). All the fractures healed, with a fracture healing time of 3-7 months (mean, 4.8 months). During the follow-up, there was no infection, loosening, implant breakage, re-fracture, and other complications. The VAS score at last follow-up was 0.8±0.3, showing significant difference ( t=7.235, P=0.000) when compared with preoperative score (5.2±3.7); the RUST score was 3.4±0.3, which was significantly higher than the preoperative score (1.5±0.7) ( t=8.336, P=0.000). According to the Schatzker-Lambert effectiveness evaluation standard, the limb function was excellent in 16 cases, good in 4 cases, fair in 1 case, and the excellent and good rate was 95.42%. Nonunion after intramedullary fixation of femoral fracture treated with auxiliary plate combined with autogenous iliac graft, autogenous bone marrow concentration and PRP gel in accordance with the "diamond concept" can not only restore the stability of the fracture ends, but also improves the biological environment of the fracture site, and can improve the rate of fracture healing.

A possible injectable tissue engineered nucleus pulposus constructed with platelet-rich plasma and ADSCs in vitro

BackgroundInjectable tissue engineered nucleus pulposus is a new idea for minimally invasive repair of degenerative intervertebral disc. The platelet-rich plasma (PRP) and adipose-derived stromal cells (ADSCs) could be harvested from autologous tissue easily. PRP contains numerous autologous growth factors and has reticulate fibrous structure which may have the potential to make ADSCs differentiate into nucleus pulposus-like cells. The goal of this study was to explore the feasibility of constructing a possible injectable tissue engineered nucleus pulposus with PRP gel scaffold and ADSCs.MethodsAfter identification with flow cytometry, the rabbit ADSCs were seeded into PRP gel and cultured in vitro. At the 2nd, 4th, and 8th week, the PRP gel/ADSCs complex was observed by macroscopy, histological staining, BrdU immunofluorescence, and scanning electron microscopy. The glycosaminoglycans (GAG) in the PRP gel/ADSCs complex were measured by safranin O staining with spectrophotometry. In PRP gel/ADSCs complex, gene expression of HIF-1α, aggrecan, type II collagen were tested by RT-PCR. The injectability of this complex was evaluated.ResultsMacroscopically, the complex was solidified into gel with smooth surface and good elasticity. The safranin O dye was almost no positive staining at 2nd week; however, the positive staining of extracellular matrix was enhanced obviously at 4th and 8th week. The HE staining and SEM demonstrated that the cells were well-distributed in the reticulate scaffold. BrdU immunofluorescence showed that ADSCs can survive and proliferate in PRP gel at each time points. The level of GAG at 4th week was higher than those at 2nd week (P < 0.05), and significant difference was also noted between 4th and 8th week (P < 0.05). HIF-1α, aggrecan, type II collagen gene expression at 4th week were much more than those at 2nd week (P < 0.05), and significant differences were also noted between 4th and 8th week (P < 0.05). The flow rate of complex was 0.287 mL/min when passed through the 19-gauge needle with the 100 mmHg injection pressure.ConclusionsOur preliminary findings suggest that the PRP gel make it possible for rabbit ADSCs differentiated into nucleus pulposus-like cells after coculture in vitro. According to the results, it is a better feasible method for construction of autologous injectable tissue engineered nucleus pulposus.

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 ...

Uso del Plasma Rico en Plaquetas para el tratamiento de las úlceras de miembro inferior. Estudio piloto

Cada vez hay más pruebas que sugieren que la cicatrización de heridas en las úlceras crónicas vasculares y del pie diabético depende del factor de crecimiento y que el suministro terapéutico de estos factores de crecimiento a las heridas por vía tópica tiene la capacidad potencial de acelerar la cicatrización de las heridas junto con el cuidado convencional de las heridas&#x0D; Se ha diseñado y proyectado un estudio prospectivo cuasiexperimental con el objetivo de evaluar la seguridad y eficacia del gel de plasma autólogo rico en plaquetas para el tratamiento de las úlceras vasculares de miembros inferiores y de pie diabético con retraso de la cicatrización. Mediante este estudio piloto se ha valorado la viabilidad de dicho estudio y la idoneidad del protocolo de actuación, de las variables recogidas y del instrumento de medida.&#x0D; Este estudio piloto fue realizado entre septiembre de 2018 y marzo de 2020 en el Servicio de Cirugía Vascular del Hospital Universitario Reina Sofía de Córdoba. Participaron pacientes, con úlceras vasculares o de pie diabético que presentaban retraso en el proceso de cicatrización y a los que se les aplicó PRP&#x0D; En el estudio piloto han participado cuatro pacientes con una media de edad 62,25 años. El 100% fueron hombres con lesiones de pie diabético. El 50% presentaba arteriopatía periférica asociada, con una media en el retraso de la cicatrización de 17 meses con intervalo de 12-20. El tiempo medio de cicatrización de las úlceras fue de 7,6 semanas. En ningún caso se detectaron efectos adversos relacionados con la aplicación de PRP.&#x0D; Según estos resultados preliminares, la aplicación de PRP sobre el lecho de las heridas vasculares y de pie diabético que no cicatrizan es una opción terapéutica segura y eficaz.

Platelet-rich plasma (PRP) accelerates murine patellar tendon healing through enhancement of angiogenesis and collagen synthesis

PurposeAlthough platelet-rich plasma (PRP) therapy has become an increasingly popular treatment for sports-related injuries, the molecular mechanisms of PRP on tissue healing process remain poorly understood. The aim of the present study was to develop an experimental method quantifying the efficacy of PRP with murine patellar tendon injury model, leading to future elucidation of the mechanisms of PRP on healing processes.MethodsFull-thickness defects were created in the central third of the murine patellar tendon. The prepared allogenic PRP gel was applied on the defect of the patellar tendon (PRP group), while the remaining mice served as the untreated control group. Mice were sacrificed at 2, 4, 6, 8, and 10 weeks after the operation, with histological sections obtained in each time point (n = 4 / time point / group). Semi-quantitative histological evaluation was performed in accordance with the Bonar score. The variables included in this scoring system were cell morphology, ground substance, collagen arrangement, and vascularity, with higher grades indicating worse tendon structures. In addition, the ratio of the collagen fibers to the entire tendon tissue (FT ratio) was measured using KS400 software as a quantitative histological evaluation.ResultsThe total Bonar score in the PRP group was significantly lower than in control group. With regard to the variables in the Bonar score, the vascularity score was significantly higher in the PRP group at 2 and 4 weeks, while the collagen arrangement score was significantly lower in the PRP group at 8 weeks. Based on a quantitative evaluation, the recovery speed of the patellar tendon determined by FT ratio was significantly faster in the PRP group than in the control group at 6 and 8 weeks.ConclusionsWe have developed an experimental method for histological and quantitative evaluation of the effects of PRP on tissue healing using murine patellar tendon injury model. The results of this study suggest that the local application of PRP could enhance the tissue-healing process both directly through action on localized cells and indirectly through the recruitment of reparative cells through the blood flow. Further investigations will be needed to confirm the mechanisms of PRP in tissue-healing processes with the development of this experimental model.

Clinical strategies for preservation of the exposed implant in chronic wounds and wound repair

Objective: To explore the clinical strategies for preservation of the exposed implant in chronic wounds and wound repair. Methods: From January 2016 to January 2019, totally 8 patients (4 males and 4 females, aged 10 to 73 years) sustaining postoperative chronic wounds with exposed implants were admitted to the Fourth Medical Center of PLA General Hospital. There were 2 cases of abdominal patch exposure after abdominal trauma surgery, 2 cases of titanium plate exposure post craniocerebral surgery, 3 cases of internal fixator exposure post orthopedic surgery, and 1 case of cerebrospinal fluid drainage tube exposure after craniocerebral surgery. The wound exudate was collected for bacterial culture on admission. On the basis of glycemic control and correction of anemia and hypoproteinemia, thorough wound debridement was performed as soon as possible and the wound area after debridement ranged from 2.0 cm×0.5 cm to 6.0 cm×5.0 cm. The wounds of 4 patients were immediately closed after debridement, including 1 case by primary closure, 1 case by primary closure after local filling of platelet rich plasma gel, and 2 cases by local flap transplantation, with flap size of 10.0 cm×8.0 cm and 12.0 cm×8.0 cm, respectively. The donor sites of flaps were sutured directly and all the incisions were treated with continuous vacuum sealing drainage (VSD) after surgery. The other 4 patients were treated with continuous VSD after debridement to improve the wound bed. The wound of 1 case healed gradually, 1 case received direct wound suturing, and the wounds of 2 cases were repaired with thin split-thickness skin grafts from the thigh or the head. The results of bacterial culture of wound exudate on admission, wound healing post surgery, and follow-up were observed and recorded. Results: The bacterial culture of wound exudate on admission was positive in 6 patients, and 10 strains of bacteria were isolated with Staphylococcus epidermidis as the main pathogen. All the skin grafts or flaps of patients survived post surgery, with the incisions and wounds healed and all the implants preserved. After 1 to 3 years of follow-up, no recurrence of wound was found in any patient. Conclusions: The postoperative chronic wounds with exposed implants can be closed in primary stage by direct suturing or flap transplantation if it is clean enough on the basis of thorough debridement. The wounds with large defects or serious infection can be treated with continuous VSD firstly and then closed with direct suturing or skin grafting for delayed wound closure, thereby to reach the treatment goal of preserving the implants and repairing the wounds simultaneously.

Efficacy of Platelet Rich Plasma (PRP) Gel in Bone Regeneration of Periapical Cystic Lesion

Efficacy of Platelet Rich Plasma (PRP) Gel in Bone Regeneration of Periapical Cystic Lesion

820 Filling Injection of Platelet-rich Plasma Gel as A New Method to Treat En Coup de Sabre Scleroderma

Platelet-rich Plasma (PRP) plays an important role on the tissue regeneration process. A new preparatioin method of PRP provides an filling injection product which was named Platelet-rich Plasma Gel (PRPG) and could provied synergic effects on skin elasticity, dermal remodeling and re-vascularization. The aim of this pilot study was to assess the clinical benefit of PRPG filling injection on the treatment of en coup de sabre scleroderma. Five patients who were diagnosed under the confirmation of histopathology, and assessed by ultrasonography. Treatment was administered with PRP at a concentration 3.5 times above baseline. And under sterile condition, pre-seperated PRP was aspirated into several needle tubes, gradually heated in a dry bath machine, and prepare PRPG under the terminal temperature of 70 centigrade for 14 minutes. Under swelling anesthesia, subcutaneous tissue gaps were formed. Then PRPG was safely filled in these gaps without the risk of injection into the blood vessels. Therefore, a kind of structure mimic subcutaneous soft tissue was performed to slowly release cell and growth factors which enhance the regeneration effects on the remodeling of dermal tissue and reconstruction of vascular network. The subjective symptoms of pain and tightness were significantly relieved after at least one time of injecton. And after completion of 3 cycles of treatments at monthly intervals, objective lesions showed the improvement of skin elatisity, dermal thickness, subcutaneous tissue thickness and subcutaneous vascular network density. Even hair growth can be observed in those atrophy scalp filed. The main limitations of this study were the low number of cases, lack of a comparison group and the difficulty of identifying the exact role of each factor which would be studied in next clinical trial. However, PRPG is a good alternative of tissue filler substitution instead of hyaluronic acid and collagen, and represents a new and potentially regenerative treatment option for en coup de sabre scleroderma with minimal associated side effects.

Evaluation of Quality of Life in Patients with Chronic Leg Wounds: Can Platelet-rich Plasma Therapy Help?

Aim. The aim of the study was to evaluate and compare the quality of life (QoL) using platelet-rich plasma gel (PRP) and conventional treatment of chronic leg wounds. Methods. Randomized clinical trial was carried out in Hospital of Lithuanian University of Health Sciences Kaunas Clinics during 2014–2018. Patients (n = 69) included in the study were randomly grouped into 2 groups: 1) PRP, 2) Control. SF-36 questionnaire was used to evaluate QoL, visual analog scale was used to evaluate persistent pain associated with ulcer and wound exudate volume was also evaluated. Statistical analysis were performed with SPSS 23.0 package. Results. Patients in PRP group at the end of the treatment rated their QoL over control group patients (p &lt; 0.05). Wound associated pain (PRP – 1.54; control – 2.85; p = 0.015) and pain associated sleep disturbance (p &lt; 0.001) was lower in PRP group patients. Wound exudate volume was lower in PRP group patients at the end of the treatment (p &lt; 0.05). Conclusion. The treatment with PRP is associated with less wound associated pain, less-common sleep disturbance, reduced wound secretion and improved quality of life compared to conventional treatment.

Evaluation of platelet-rich plasma gel as an angiogenesis-inducing agent in canineadvancement skin flaps

ABSTRACT: This work aimed to evaluate the effect of platelet-rich plasma (PRP) on advancement skin flaps in dogs regarding improvement of vascularization, with focus on increasing its viable area, since there are reports that it is a potential angiogenesis stimulator. The experimental group was composed of eight adult bitches, in which two advancement skin flaps were made in the ventral abdominal region. No product was applied in the control flap (CF), while PRP was used in the contralateral flap, called treated flap (TF). The areas were clinically evaluated every two days until the 7th postoperative day regarding skin color and presence of necrosis. At 10 days, both flaps were removed and submitted to histological examination and blood vessel morphometry. The vessels counted in each group were statistically analyzed by the F-test at 1% probability. Results showed no significant difference in macroscopic changes in the wound, or CF and TF vascularization, thus suggesting that PRP gel did not improve advancement skin flap angiogenesis in bitches under the experimental conditions in which this research was developed.

Effect of platelet-rich plasma on colon anastomosis in rats in which hyperthermic intra-peritoneal chemotherapy was performed using 5-fluorouracil.

Hyperthermic intra-peritoneal chemotherapy (HIPEC) performed in patients with peritoneal carcinomatosis has a cytotoxic effect on tumour cells. This cytotoxic effect also adversely affects the wound healing of anastomosis, which is frequently undertaken in this patient group, and causes anastomotic leakage and intestinal fistulas. Platelet-rich plasma (PRP) gel has been used in wound healing and has shown efficacy. We investigated the effect of PRP gel on colon anastomosis healing in rats treated with 5-fluorouracil (5-FU). Twenty-four rats were divided into three groups, each containing eight rats: group 1 (control) underwent colon anastomosis alone; group 2 (5-FU) underwent a colon anastomosis and HIPEC; and group 3 (5-FU + PRP) underwent a colon anastomosis and HIPEC and received topical PRP gel. The rats were sacrificed on the post-operative day 7 and the anastomotic bursting pressure (ABP) was measured. Tissue samples were obtained to measure the hydroxyproline level and investigate the histopathological changes on the anastomosis line. ABP was higher in the control and 5-FU + PRP groups than in the 5-FU group (P = 0.009, P = 0.047). The tissue hydroxyproline levels were higher in the control and 5-FU + PRP groups than in the 5-FU group (P = 0.001, P = 0.030). The histopathological findings of the 5-FU + PRP group were better than those of the 5-FU group. This study showed that the application of PRP gel to colon anastomoses increased ABP in rats treated with HIPEC using 5-FU. It also showed positive effects on anastomotic healing by increasing the tissue hydroxyproline levels on the anastomosis line and reducing the inflammatory response.

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.

Platelet-rich plasma enhances the repair capacity of muscle-derived mesenchymal stem cells to large humeral bone defect in rabbits

Mesenchymal stem cell-based therapy is a highly attractive strategy that promotes bone tissue regeneration. The aim of the present study was to evaluate the combination effect of muscle-derived mesenchymal stem cells (M-MSCs) and platelet-rich plasma (PRP) on bone repair capacity in rabbits with large humeral bone defect. Precise cylindrical bone defects of 10 mm diameter and 5 mm depth were established in rabbit humeral bones, which were unable to be repaired under natural conditions. The rabbits received treatment with M-MSCs/PRP gel, M-MSCs gel, or PRP gel, or no treatment. The bone tissue regeneration was evaluated at day 0–90 after surgery by HE morphological staining, Lane-Sandhu histopathological scoring, tetracycline detection, Gomori staining and micro-computed tomography. Beyond that, Transwell assay, CCK8 assay, Western blot analysis and ALP activity detection were performed in M-MSCs in vitro with or without PRP application to detect the molecular effects of PRP on M-MSCs. We found that the repair effect of M-MSCs group or PRP group was limited and the bone defects were not completely closed at post-operation 90 d. In contrast, M-MSCs/PRP group received obvious filling in the bone defects with a Lane-Sandhu evaluation score of 9. Tetracycline-labeled new bone area in M-MSCs/PRP group and new mineralized bone area were significantly larger than that in other groups. Micro-computed tomography result of M-MSCs/PRP group displayed complete recovery of humeral bone at post-operation 90 d. Further in vitro experiment revealed that PRP significantly induced migration, enhanced the growth, and promoted the expression of Cbfa-1 and Coll I in M-MSCs. In conclusion, PRP application significantly enhanced the regeneration capacity of M-MSCs in large bone defect via promoting the migration and proliferation of M-MSCs, and also inducing the osteogenic differentiation.

Combined Use of Autologous Stromal Vascular Fraction Cells and Platelet-Rich Plasma for Chronic Ulceration of the Diabetic Lower Limb Improves Wound Healing.

The discovery of stromal vascular fraction cells and platelet-rich plasma in promoting tissue regeneration has prompted a new idea for the treatment of chronic diabetic ulcer of the lower limb. The study aim was to evaluate the clinical efficacy of a new method that applied stromal vascular fraction cells and platelet-rich plasma together in the treatment of recalcitrant chronic diabetic ulcer. We conducted a single-center, prospective, open, noncontrolled study. Four patients (5 ulcers in total) who had received standard treatment for diabetic ulcer for at least 3 months that failed to heal was enrolled. All patients were treated with surgical debridement, cell suspension (stromal vascular fraction cells suspended by platelet-rich plasma) injection into the wound, and platelet-rich plasma gel coverage. Wounds were measured every week after treatment using a 2-dimensional digital camera and a 3-dimensional wound measurement device. All patients were followed-up for 4 months after the treatment. Four of the 5 ulcers healed completely within a mean of 71.75 ± 29.57 days. The average proportion of granulation tissue achieved 100% within 4 weeks for all cases. The wound size decreased to less than half of the original size for all cases 4 weeks after the treatment. Findings revealed that the new treatment is efficient to achieve wound healing in patients with recalcitrant chronic diabetic ulcer of lower limb.