CLINICAL APPLICATION OF PLASMA-RICH PLASMA (see ACR 2007)
Pietrzak et al (2005), from Warsaw , has emphasized the platelets central role in homeostasis and wound healing. The latter is of special interest to those in the rejuvenation business. Of importance, is that once platelet activation occurs, up to seven secretory proteins (mitogens, growth factors, cytokines) are released locally into the wound that can definitely influence the wound healing cascade. Robert Marx, a pioneer in the field of the use of PRP defines it as follows: "platelet-rich plasma (PRP) is an autologous concentration of human platelets in a small volume of plasma" (J. Oral Maxillofac Surg 62:489-496, 2004: see his textbook dated 2005 and given out by Quintessence Books). PRP is therefore relevant to wound healing and dental implantation surgery. It would appear as if the platelet-derived growth factors play an important part in the wound healing cascade. Regenkit® is a useful kit to produce and deliver PRP.
Clinical Areas where PRP is being tested: "Wound Pharmacology"
- Cosmetic surgery and aesthetic medicine (wrinkles amelioration)
- Haemostatic agent to reduce capillary oozing from surgical beds (face lifts, reduction mammaplasties, abdominoplasties (see Plast. Reconstr. Surg 107:229, 2001).
- Maxillo- facial and oral surgery (sinus lifting augmentation and dental implantation). See Professor Marx's textbook regarding PRP.
- Bone grafting for dental implants. Repair of maxillo-oral fistulas (extractions, dental implants, periodontal surgery, bone grafting): Implant dentistry.
- Lumbar Spinal fusions (spinal fusion).
- Chronic ulceration: diabetic and non-diabetic ulceration.
- Skin grafting (donor and recipient site).
- Wound healing (bone and soft tissue healing).
Summary : Commercially available systems are currently in use to procure autologous platelet-rich plasma (PRP) in a side-room or theatre. Patient selection is important as well as quality assurance of the preparation. Marx, a doyen in the field has emphasized that FDA-approved centrifuges should be utilized when preparing PRP. PRP may well still have a role to play in patients with chronic wounds that have failed to heal with appropriate conservative therapy, nonunion, or high risk osseus defects (Advances in Therapy, 23:218-237, 2006).
Click here to read more about:
PLATELET-RICH PLASMA (PRP) - AND TISSUE REGENERATION BY GROWTH FACTORS: PUSHING OUT HORIZONS IN REGENERATIVE AND AESTHETIC MEDICINE WITH PERSPECTIVES FROM ASIA 2007.
- Marx R. E. Platelet-Rich Plasma: Evidence to support its use. J Oral Maxillofac Surg. 62:489-496, 2004.
- Pietrzak W. S, Eppley B. L. Platelet-Rich Plasma: Biology and New Technology. J Craniofasc Surg, 2006,16:1043-1054.
- Robiony M, Polini F, Costa F, Politit M. Osteogenesis distraction and Platelet-Rich Plasma for bone Restoration of the severely atrophic mandible: preliminary results. J Oral Maxillofac Surg, 60: 630-635, 2002.
- Della Valle A, Sammartino G, Marenzi G, Tia Mariano, Di Lauro A. E, Ferarri F, L. Lo Muzio. Prevention of post-operative bleeding in anticoagulated patients undergoing oral surgery: use of Platelet-Rich Plasma Gel. J Oral Maxillofac Surg, 61:1275-1278, 2003.
- Freymillar E. G, Aghaloo T. Platelet-Rich Plasma: Ready or Not? J Oral Maxillofac Surg, 62: 484-488, 2004.
- Man D, Plosker H, Windland-Brown J. E. The use of autologous platelet-rich plasma (platelet-gel) and autologous platelet-poor plasma (fibrin glue) in cosmetic surgery. Plast Reconstr Surg. 107: 229-237, 2000.
- Eppley B. L, Woodell J. E, Higgins J. Platelet quantification and Growth factor Analysis from Platelet-rich plasma: Implications for wound healing. Plast Reconstr Surg, 114:1502-1508, 2004.
- Roukis T. S, Zgonis T, Tiernan B. Autologous Platelet-Rich Plasma for wound and Osseous Healing: A review of the literature and commercially available products. Advances in Therapy. 23,:218-237, 2006.
- Eppley B. L, Pietrzak W. S, Blantou M. Platelet-rich Plasma. A Review of Biology and Applications in Plastic Surgery. Plast Reconstr Surg, 118:147 e-159e, 2006.
- Bhanot S, Alex J. C. Current applications of platelet gels in facial plastic surgery. Facial Plastic Surgery, 18:27-33, 2002.
- Marlovits S, Mousavi M, Gäbler C, Erdös J, Vécsei V. A new simplified technique for producing platelet-rich plasma: A short technical note. Europ Spine J 13 (Suppl1): S102-S106, 2004.
- Cenni E, Ciapetti G, Pagani F, Giunti A, Baldaini N. Effects of activated platelet concentrates on human primary cultures of fibroblasts and osteoblasts. J Periodontol, 76:323-8, 2005.
- Du Toit DF, Otto MJ, Kleintjes WJ, Morkel JA. Current controversies in the application of platelet-rich plasma and growth factors in maxillo-facial surgery and oral surgery. SADJ 2007. In press.