PRP-TISSUE REGENERATION REFERS TO REGENERATION OF A DAMAGED OR LOST PART (WIKIPEDIA)

Table-1: COSMETIC/AESTHETIC PRP-UPDATE 2010. BIOMEDICAL SCIENCE , CLINICAL AND BASIC SCIENCES REGARDING PLATELET-RICH PLASMA (PRP): After Marx 2005 et al.

• PRP releases seven growth-factors (GF) from activated platelets: these GF promote healing and regeneration ( tissue healing and biocellular regeneration).Thus, the GF are relevant to wound-healing
• PRP is autogenous blood clot and contains concentrated numbers of platelets ( about 4-7 times baseline is needed for clinical benefit)
• The alpha-granules of the platelet store the GF (PDGF, TGF,VEGF,EGF): GF are proteins and need to be biologically active to work: biological actions: stimulate mesenchymal stem cells and resident adult cells to replicate, osteoblast replication, endothelial cell-replication, fibroblast and osteoblast-replication to produce collagen, enhance bone-regeneration, stimulate matrix-formation, stimulation of pericytes, epidermal-regeneration and re-surfacing
• PRP is not stem-cell therapy, but is non-invasive and fairly safe
• PRP does not contain stem cells of any relevance, but may be directed at resident stem cells that are up-regulated after injection to replicate together with other mesenchymal cells
• The platelet alpha-granules also contain cell-adhesion molecules and involved with vitronectin, fibronectin, fibrin
• The GF have two active sites each and are called dimers
• PRP: 94% platelets, 5% RBC, 1% WBC and no stem cells of note
• Enhancement of autogenous bone-grafts used in maxilla-facial surgery and orthopaedics
• PRP can be  considered for facial-regeneration /rejuvenation but the effects only last for 6-months and other complimentary treatments such as RF are needed to back-up or bolster the plasma. Stand-alone PRP-treatment is insufficient to reverse or ameliorate ageing and add-ons are needed
• Enhanced proliferation of skin basal cells ( stem cells of the epithelium): following blood-clot formation (improved donor-site healing  after skin-graft)
• Enhancement of osteointegration ( relevant to implant-surgery)
• NB: Poor technique can render poor quality and PRP enrichment: one needs to concentrate viable bioactive platelets. Therefore the best PRP processing device is needed.
• PRP can be used during stem cell transplantation and the biological action is referred to as: PROLIFERATION-PROMOTING EFFECT (may be used with human adipose-derived stem cells and human dermal-fibroblasts: see Kakudo et al,  Plast Reconstruct Surg 2008: 1352-60). Therefore PRP application can be utilised for cell-based, soft-tissue engineering and wound-healing
• The topical efficacy, and level - evidence, has been demonstrated in the treatment of diabetic-foot ulceration. Numerous indications for PRP are described in cranio-facial surgery:  bone grafting, rhytidectomy, face-lift, fat-grafting and transfer
• Potent cell proliferation enhancer ex vivo using fibroblasts, adipose-derived stem cells, keratinocytes
• Controversial areas: PRP-MESOTHERAPY for facial rejuvenation and repair of solar-aged changes, sagging, wrinkling. The problems include unpredictable inconsistency, poor and no-response in some clients. It is an international experience. This is a feature of biologicals and applies to stem cell application at the time of posting. Need for additional facial back-up RF treatment is mandatory after PRP-MESOTHERAPY to reach benchmark cosmetic-output. Is it not the RF that is working or the PRP? For the moment cosmetic-scientists are not sure if subdermal and subcutaneous injections of PRP are superior to other established cosmetic treatments. Established cosmetic clinics have demonstrated that PRP-FACELIFT is not superior to superficial chemical-peel plus LED, IPL or fractionated laser. BOTOX and fillers are far superior to PRP in gaining quick results. PRP- mesotherapy is far more costly than BOTOX or DYSPORT. PRP is not stem cell therapy and cannot turn back the ageing clock completely. More robust science and evidence is needed. But it seems that PRP may well have a place in the cosmetic armamentarium of the cosmetic surgeon, dermatologist and aesthetic physician. PRP is more established in therapeutics at the clinic but not in the beauty salon.
• Dermatological or plastic surgery consultation. Such a consultation is essential to assess if you are a suitable client for such treatment
• References: Marx and Garg 2005, Quintessence; Kumar et al, Robbin’s Basic Pathology, 2007, 8th Edition, International Edition; Du Toit et al, The Specialist Forum 2007:7; 30-31.
• PRODUCTS AVAILABLE IN RSA:  Regen-PRP® (REGENKIT®) (Cost: R800 per tube); MyCells® (Neokit®) (costs: R1300 per tube).PRP-mesotherapy demonstration of technique is available on the Internet: See U-Tube demos by various doctors.
• DISCLAIMER: This site provides no medical or cosmetic advice or recommendation and therefore an aesthetic expert should be consulted regarding any facial treatment, treatment choices to the neck, décolleté or dorsal aspects of the hands.
• Formulation: BIOMED Expert and Specialist.
• WEBSITE UPGRADING AND UPDATING: 16 November 2009. See BOLAND CELL menu: PRP UPDATE 2010.