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Platelet Membrane Proteins as Pain Biomarkers in Patients with Severe Dementia. Biomedicines 2023; 11:biomedicines11020380. [PMID: 36830917 PMCID: PMC9953643 DOI: 10.3390/biomedicines11020380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/31/2023] Open
Abstract
Pain is one of the most frequent health problems, and its evaluation and therapeutic approach largely depend on patient self-report. When it is not possible to obtain a self-report, the therapeutic decision becomes more difficult and limited. This study aims to evaluate whether some membrane platelet proteins could be of value in pain characterization. To achieve this goal, we used 53 blood samples obtained from palliative patients, 44 with non-oncological pain and nine without pain. We observed in patients with pain a decrease in the percentage of platelets expressing CD36, CD49f, and CD61 and in the expression levels of CD49f and CD61 when compared with patients without pain. Besides that, an increase in the percentage of platelets expressing CD62p was observed in patients with pain. These results suggest that the levels of these platelet cluster differentiations (CDs) could have some value as pain biomarkers objectively since they are not dependent on the patient's participation. Likewise, CD40 seems to have some importance as a biomarker of moderate and/or severe pain. The identification of pain biomarkers such as CD40, CD49f, CD62p and CD61 can lead to an adjustment of the therapeutic strategy, contributing to a faster and more adequate control of pain and reduction in patient-associated suffering.
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Mirhaj M, Tavakoli M, Varshosaz J, Labbaf S, Jafarpour F, Ahmaditabar P, Salehi S, Kazemi N. Platelet rich fibrin containing nanofibrous dressing for wound healing application: Fabrication, characterization and biological evaluations. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 134:112541. [DOI: 10.1016/j.msec.2021.112541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/25/2021] [Accepted: 11/06/2021] [Indexed: 12/27/2022]
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3
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Capion SC, Jørgensen HBL, Ågren MS, Daugaard H, Ribel-Madsen S, Marando D, Johansson PI, Salado J, Halschou-Jensen PM, Borgwardt A, Andersen JR. The wound healing effect of local leukocyte platelet-rich plasma after total hip arthroplasty: A randomized controlled trial. Wound Repair Regen 2021; 29:988-995. [PMID: 34546614 DOI: 10.1111/wrr.12967] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/17/2021] [Accepted: 09/02/2021] [Indexed: 12/12/2022]
Abstract
Rapid wound closure is important after arthroplasty procedures to prevent postoperative complications. Platelets are rich in growth factors and leukocytes contribute to innate immunity. We hypothesized that topical leukocyte platelet-rich plasma (L-PRP) derived from the blood of patients would be beneficial to wound healing. In this randomized controlled trial, patients subjected to elective total hip arthroplasty (THA) were assigned by concealed allocation either L-PRP application onto the sutured fascia or no application (control) after the THA intervention. In addition, all patients received 1.5 g protein/kg, 5 g L-arginine, 500 mg vitamin C and 44 mg zinc daily over the 4-week postoperative period to obtain optimal nutrition. The primary endpoint was complete healing of the skin incision. The secondary endpoints were blood transfusions, length of hospital stay, pain and wound infections. Sixteen patients in the L-PRP group and 17 patients in the control group completed the trial. L-PRP treatment accelerated complete wound healing after 3 weeks (seven in the L-PRP group vs. zero in the control group, p = 0.003) and after 4 weeks (12 in the L-PRP group vs. six in the control group, p = 0.037). No postoperative superficial wound infections occurred within 4 weeks, and there were no significant differences in the other secondary outcomes. L-PRP generated in 10 sex-matched healthy volunteers revealed increased concentrations of platelets (5.8-fold) and leukocytes (2.3-fold) compared with those in whole blood. Furthermore, the concentration of keratinocyte mitogen epidermal growth factor in L-PRP (380 ± 130 pg/ml, mean ± SD) was higher (p < 0.001) than that in serum (130 ± 26 pg/ml). In conclusion, a single intraoperative local application of L-PRP promoted wound healing after THA, possibly mediated by EGF receptor agonists.
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Affiliation(s)
- Susanne Clemen Capion
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Henrietta B L Jørgensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Magnus S Ågren
- Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Dermatology and Copenhagen Wound Healing Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Daugaard
- Department of Orthopaedic Surgery, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark
| | - Søren Ribel-Madsen
- Department of Orthopaedic Surgery, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark
| | - Debora Marando
- Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - José Salado
- Blood Bank, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Arne Borgwardt
- Department of Orthopaedic Surgery, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark
| | - Jens Rikardt Andersen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
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Bilgen F, Ural A, Bekerecioglu M. Platelet-rich fibrin: An effective chronic wound healing accelerator. J Tissue Viability 2021; 30:616-620. [PMID: 34275723 DOI: 10.1016/j.jtv.2021.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Platelets are cells that play a central role in wound healing, and they are the main source of the growth factor complex that plays the main role in natural wound healing. It is aimed to present the beneficial effects of topical application of PRF on chronic ulcers that do not respond to standard wound care in cases of chronic ulcers that require a long treatment process and high costs. MATERIALS AND METHODS The study included 16 patients between the dates of January 2017 and September 2019. The study was approved by the local ethics board and planned retrospectively. RESULTS The mean number of PRF applications in the patients was 4.37 (range: 1-8), while the wounds of 10 patients were completely closed up to the mean number of applications, and at least 50% of the wounds of 4 patients were closed up to the mean number of applications. DISCUSSION Choukroun's platelet-rich fibrin may be considered as a 2nd-generation platelet concentration. Its preparation protocol is reported to be highly simple and low-cost. CONCLUSION PRF is a safe, practical, easy to use adjuvant treatment method which has a potential for closing chronic wounds.
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Affiliation(s)
- Fatma Bilgen
- KahramanmaraşSutcu Imam University School of Medicine, Plastic, Reconstructive and Aesthetic Surgery, Kahramanmaras, Turkey.
| | - Alper Ural
- KahramanmaraşSutcu Imam University School of Medicine, Plastic, Reconstructive and Aesthetic Surgery, Kahramanmaras, Turkey.
| | - Mehmet Bekerecioglu
- KahramanmaraşSutcu Imam University School of Medicine, Plastic, Reconstructive and Aesthetic Surgery, Kahramanmaras, Turkey.
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5
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An Y, Lin S, Tan X, Zhu S, Nie F, Zhen Y, Gu L, Zhang C, Wang B, Wei W, Li D, Wu J. Exosomes from adipose-derived stem cells and application to skin wound healing. Cell Prolif 2021; 54:e12993. [PMID: 33458899 PMCID: PMC7941238 DOI: 10.1111/cpr.12993] [Citation(s) in RCA: 198] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/14/2020] [Accepted: 01/02/2021] [Indexed: 02/06/2023] Open
Abstract
Skin wound healing is an intractable problem that represents an urgent clinical need. To solve this problem, a large number of studies have focused on the use of exosomes (EXOs) derived from adipose‐derived stem cells (ADSCs). This review describes the mechanisms whereby ADSCs‐EXOs regulate wound healing and their clinical application. In the wound, ADSCs‐EXOs modulate immune responses and inflammation. They also promote angiogenesis, accelerate proliferation and re‐epithelization of skin cells, and regulate collagen remodelling which inhibits scar hyperplasia. Compared with ADSCs therapeutics, ADSCs‐EXOs have highly stability and are easily stored. Additionally, they are not rejected by the immune system and have a homing effect and their dosage can be easily controlled. ADSCs‐EXOs can improve fat grafting and promote wound healing in patients with diabetes mellitus. They can also act as a carrier and combined scaffold for treatment, leading to scarless cutaneous repair. Overall, ADSCs‐EXOs have the potential to be used in the clinic to promote wound healing.
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Affiliation(s)
- Yang An
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Shuyan Lin
- Hearing Ctr, Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaojie Tan
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Shiou Zhu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Fangfei Nie
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Yonghuan Zhen
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Luosha Gu
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Chunlei Zhang
- Institute of Systems Biomedicine, Peking University, Beijing, China
| | - Baicheng Wang
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Wei Wei
- Clinical Stem Cell Research Center, Peking University Third Hospital, Beijing, China
| | - Dong Li
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Junhao Wu
- Hearing Ctr, Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
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Hassan H, Quinlan DJ, Ghanem A. Injectable platelet-rich fibrin for facial rejuvenation: A prospective, single-center study. J Cosmet Dermatol 2020; 19:3213-3221. [PMID: 32852873 DOI: 10.1111/jocd.13692] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Autologous platelet-derived preparations have been used in many surgical fields to improve healing outcomes, with benefits reported in several aesthetic indications. AIMS This single-center, prospective, uncontrolled study evaluated the efficacy of injectable platelet-rich fibrin (i-PRF) for facial skin rejuvenation using an objective skin analysis system and validated patient-reported outcome measures. PATIENTS/METHODS PRF® PROCESS system technology was used to prepare i-PRP. Eleven healthy female individuals were included in the study and over 3-months received monthly intradermal injections of i-PRF in 3 facial regions: malar areas (1 mL each side), nasolabial fold (0.5 mL each side), and upper lip skin above the vermilion border (1 mL). The efficacy of the procedures was assessed by objective skin analysis (VISIA® ) and a subjective patient-reported outcome (FACE-Q) assessment at baseline and after 3 months. RESULTS A significant improvement in skin surface spots (P = .01) and pores (P = .03) was seen at 3-months follow-up. Other variables, such as skin texture, wrinkles, ultraviolet spots, and porphyrins, showed a numerical improvement. FACE-Q scales that measure satisfaction with appearance all showed a significant improvement from baseline, including satisfaction with skin (P = .002), satisfaction with facial appearance (P = .025), satisfaction with cheeks (P = .001), satisfaction with lower face and jawline (P = .002), and satisfaction with lips (P = .04). No major adverse effects were reported. CONCLUSIONS A series of three i-PRF injections resulted in significant rejuvenation of the face skin at 3-month follow-up, as shown by improved skin analysis parameters and patient self-assessment scores.
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Affiliation(s)
- Haidar Hassan
- Academic Plastic Surgery, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Daniel J Quinlan
- Academic Plastic Surgery, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Ali Ghanem
- Academic Plastic Surgery, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Jasmine S, Thangavelu A, Krishnamoorthy R, Alshatwi AA. Platelet Concentrates as Biomaterials in Tissue Engineering: a Review. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2020. [DOI: 10.1007/s40883-020-00165-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chen J, Wan Y, Lin Y, Jiang H. Platelet-rich fibrin and concentrated growth factors as novel platelet concentrates for chronic hard-to-heal skin ulcers: a systematic review and Meta-analysis of randomized controlled trials. J DERMATOL TREAT 2020; 33:613-621. [PMID: 32441168 DOI: 10.1080/09546634.2020.1773386] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Jianguo Chen
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yingying Wan
- China Academy of Chinese Medical Sciences, Xi Yuan Hospital, Beijing, China
| | - Yan Lin
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haiyue Jiang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Yuvasri G, Rai R. Comparison of Efficacy of Autologous Platelet-Rich Fibrin versus Unna's Paste Dressing in Chronic Venous Leg Ulcers: A Comparative Study. Indian Dermatol Online J 2020; 11:58-61. [PMID: 32055510 PMCID: PMC7001417 DOI: 10.4103/idoj.idoj_119_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Chronic venous leg ulcers are difficult to treat and recurrences are common. Among various modalities of treatment, platelet-rich fibrin (PRF) has shown promising results in ulcer healing by providing necessary growth factors. Unna's paste dressing has also proven to enhance wound healing. Aim: The aim of this study is to compare the efficacy of autologous PRF versus Unna's paste dressing in chronic venous leg ulcer patients and to compare the mean reduction in ulcer area at the end of 4 weeks. Materials and Methods: Twenty patients with chronic venous leg ulcers were randomly divided into two groups. Group 1: Patients received PRF dressing which was repeated every week for 4 weeks. Group 2: Patients received Unna's paste dressing once a week for 4 weeks. The ulcer size was assessed with the help of photographs, and ulcer area was measured. Results: The mean reduction in the area of the ulcer size in the PRF group was 86.03% and in the Unna's paste group was 71.97%, which was not statistically significant with a P value of 0.223. Conclusion: We conclude that though there was no statistical significance between the groups, PRF showed a significant reduction in ulcer size.
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Affiliation(s)
- G Yuvasri
- Department of Dermatology, PSG Hospitals, Coimbatore, Tamil Nadu, India
| | - Reena Rai
- Department of Dermatology, PSG Hospitals, Coimbatore, Tamil Nadu, India
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Qiu H, Liu S, Wu K, Zhao R, Cao L, Wang H. Prospective application of exosomes derived from adipose-derived stem cells in skin wound healing: A review. J Cosmet Dermatol 2019; 19:574-581. [PMID: 31755172 DOI: 10.1111/jocd.13215] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 10/14/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Wound healing has always been an intractable medical problem for both clinicians and researchers and a burden for patients both physically and financially. Poor wound healing at the injury site, especially in an exposed site, is associated with an unappealing esthetic appearance in patients and also results in a bad skin barrier, tissue infection and necrosis, loss of main function in extreme cases and other serious local and systemic consequences. There is a crucial and urgent need for newer, more efficacious methods for enhancing the healing process to achieve optimal outcomes morphologically and functionally. Recent advances have focused on developing therapies that promote tissue regeneration through positively activating the mechanism of tissue repair. Given the increasing high-quality studies concerning exosomes derived from adipose-derived stem cells (ADSCs-Exos), their potential use in accelerating or supporting the wound healing process has gained increasing attention in recent years. AIMS In this review, we present an overview of the recent advances in the field of ADSCs-Exos and investigate their benefit in wound healing for skin regeneration with the expectation of providing a perspective on how to best utilize this powerful cell-free therapy in the future. METHODS A retrospective review of the published data was conducted. RESULTS Most studies have shown the possible roles of ASCs-derived exosomes (ADSCs-Exos) in cutaneous wound healing through regulation of the inflammatory response and promotion of cell proliferation, migration, differentiation, angiogenesis and matrix reconstruction to provide a new perspective strategy for the use of ASCs-Exos in skin wound healing. CONCLUSION ADSCs-Exos are likely to achieve the best functionally and cosmetic skin wound healing while avoiding undesirable consequences. ADSCs-Exos represent a novel therapeutic tool in soft tissue repair; however, further randomized, double-blind, comparative clinical trials must be performed to determine the specific mechanisms, safety and other relevant cosmetic concerns.
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Affiliation(s)
- He Qiu
- Department of Cosmetic and Plastic Surgery, Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shuo Liu
- Department of Cosmetic and Plastic Surgery, Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Kelun Wu
- Department of Cosmetic and Plastic Surgery, Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rui Zhao
- Department of Cosmetic and Plastic Surgery, Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lideng Cao
- Department of Cosmetic and Plastic Surgery, Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hang Wang
- Department of Cosmetic and Plastic Surgery, Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Andrade C, Camino J, Nally M, Quirynen M, Martínez B, Pinto N. Combining autologous particulate dentin, L-PRF, and fibrinogen to create a matrix for predictable ridge preservation: a pilot clinical study. Clin Oral Investig 2019; 24:1151-1160. [PMID: 31292776 DOI: 10.1007/s00784-019-02922-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 04/29/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The aim of this study was to describe the histological and clinical outcome of "dentin block" (a mixture of autologous particulate dentin, leukocyte- and platelet-rich fibrin (L-PRF), and liquid fibrinogen) in alveolar ridge preservation. MATERIAL AND METHODS Ten extraction sockets were grafted with "dentin block," a mixture of particulate autologous dentin with chopped leukocyte-platelet-rich fibrin (L-PRF) membranes at a 1:1 ratio, and liquid fibrinogen as a binder. Two grafted sites were followed at 4 and 5 months, and 6 sites at 6 months. Biopsies were taken from the core of the grafted site for histologic and histo-morphometric analysis. RESULTS All patients completed the study without any adverse event. The vertical and horizontal dimensions of the alveolar ridge were preserved or even increased after 4, 5, or 6 months and remained stable after 6 months of the implant placement. The histological examination revealed a median relative percentage of bone, dentin, and connective tissue of 57.0, 0.9, and 39.3%, respectively. A comparison of samples at different time points (4, 5, and 6 months) showed a progressive increase in the proportion of bone with a decrease in the proportion of dentin. The bone was compact with normal osteocytes and moderate osteoblastic activity. In 4 out of 10 samples, no dentin was observed; in the other samples, it represented 1-5% (with geometric fragments). CONCLUSIONS Dentin block showed to be a suitable bone substitute in an alveolar ridges preservation model. CLINICAL RELEVANCE The promising results of dentin block as a bone substitute in alveolar ridge preservation could have an important clinical impact considering this biomaterial brings together the regenerative potential of three autologous products with excellent biological and clinical behavior, low risk of adverse effects, and feasible acquisition.
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Affiliation(s)
- Catherine Andrade
- Department of Periodontology and Oral Implantology, Faculty of Dentistry, School of Dentistry, Universidad de Los Andes, Monseñor Álvaro del Portillo12455, Las Condes, Santiago, Chile.
| | - Joaquin Camino
- Department of Periodontology and Oral Implantology, Faculty of Dentistry, School of Dentistry, Universidad de Los Andes, Monseñor Álvaro del Portillo12455, Las Condes, Santiago, Chile
| | - Mauricio Nally
- Department of Periodontology and Oral Implantology, Faculty of Dentistry, School of Dentistry, Universidad de Los Andes, Monseñor Álvaro del Portillo12455, Las Condes, Santiago, Chile
| | - Marc Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Benjamín Martínez
- Department of Oral Diagnosis and Oral Pathology, School of Dentistry, Universidad Mayor, Santiago, Chile
| | - Nelson Pinto
- Department of Periodontology and Oral Implantology, Faculty of Dentistry, School of Dentistry, Universidad de Los Andes, Monseñor Álvaro del Portillo12455, Las Condes, Santiago, Chile.,Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
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Ozer K, Colak O. Leucocyte- and platelet-rich fibrin as a rescue therapy for small-to-medium-sized complex wounds of the lower extremities. BURNS & TRAUMA 2019; 7:11. [PMID: 31080838 PMCID: PMC6501391 DOI: 10.1186/s41038-019-0149-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 03/20/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Generally, advanced wound care resources are applied for complex wounds that pose a challenge to the medical and nursing teams. In this report, the use of leukocyte- and platelet-rich fibrin (L-PRF) is emphasized for complex wounds as an alternative, simple, inexpensive, time-saving process that does not require hospitalization and has a healing potential over that of bare soft tissue, including bone, tendon, and ligaments. The aim of this study is to extend the use of L-PRF in small-to-moderate-sized complex wounds of lower extremities in which L-PRF maintains the sensitive structures viable. METHODS Between January 2016 and December 2017, 17 small-to-moderate-sized complex wounds of lower extremities treated with L-PRF were recruited from the plastic and reconstructive surgery clinic in Aydin State Hospital, Turkey. The treatment was administered twice per week in the outpatient clinic. Depending on the size and extension of the complex wound, two to five blood samples were collected into 8.5 ml dry, glass vacuum tubes with no anticoagulant, and samples were immediately centrifuged at 1630×g for 5 min to obtain L-PRF. Complete healing was defined as the day of complete wound epithelialization. RESULTS The median values of the initial wound size and wound duration were 12 cm2 (interquartile range, 6 to 23 cm2) and 8 months before first admission (interquartile range, 4 to 18 months), respectively. All wounds showed significant improvements after L-PRF therapy and full closure after a median of 18 months, with an interquartile range of 11 to 34 months of L-PRF applications. There were recurrences of wounds during the first 6 months after therapy. No adverse events were observed. CONCLUSIONS Our results add to the growing evidence that L-PRF treatments protect and maintain bare soft tissue structures viable, facilitate the formation of granulation tissue and epithelization, and remarkably reduce the need for additional soft tissue surgeries in small-to-medium-sized complex wounds.
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Affiliation(s)
- Kadri Ozer
- Aydin State Hospital, Plastic, Reconstructive and Aesthetic Surgery Clinic, 09100 Aydin, Turkey
| | - Ozlem Colak
- Istanbul Okmeydani Training and Research Hospital, Plastic, Reconstructive and Aesthetic Surgery Clinic, 34384 Istanbul, Turkey
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Yamakawa S, Hayashida K. Advances in surgical applications of growth factors for wound healing. BURNS & TRAUMA 2019; 7:10. [PMID: 30993143 PMCID: PMC6450003 DOI: 10.1186/s41038-019-0148-1] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 03/13/2019] [Indexed: 12/15/2022]
Abstract
Growth factors have recently gained clinical importance for wound management. Application of recombinant growth factors has been shown to mimic cell migration, proliferation, and differentiation in vivo, allowing for external modulation of the healing process. Perioperative drug delivery systems can enhance the biological activity of these growth factors, which have a very short in vivo half-life after topical administration. Although the basic mechanisms of these growth factors are well understood, most have yet to demonstrate a significant impact in animal studies or small-sized clinical trials. In this review, we emphasized currently approved growth factor therapies, including a sustained release system for growth factors, emerging therapies, and future research possibilities combined with surgical procedures. Approaches seeking to understand wound healing at a systemic level are currently ongoing. However, further research and consideration in surgery will be needed to provide definitive confirmation of the efficacy of growth factor therapies for intractable wounds.
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Affiliation(s)
- Sho Yamakawa
- Division of Plastic and Reconstructive Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Kenji Hayashida
- Division of Plastic and Reconstructive Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501 Japan
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Özçay N, Özdemir H, Besim H. Role of platelet-rich fibrin on intestinal anastomosis wound healing in a rat. ACTA ACUST UNITED AC 2018; 13:045006. [PMID: 29565259 DOI: 10.1088/1748-605x/aab8e1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The aim of the present study is to investigate the role of platelet-rich fibrin (PRF) on the intestinal anastomotic wound healing in a mesenteric ischemia/reperfusion (I/R) rat model. METHODS Forty male Sprague Dawley rats were allocated into four groups: Group I (n = 10): anastomosis to normal bowel; Group II (n = 10): anastomosis after I/R injury; Group III (n = 10): anastomosis and PRF; Group IV: anastomosis after I/R and PRF. Animals were followed up for 7 days, then sacrificed. Anastomotic complications, anastomosis bursting pressures and histopathologic evaluations of the anastomoses were the study parameters. RESULTS The I/R injury caused more anastomotic adhesion and very low anastomotic bursting pressure when compared with the other groups (p < 0.01). Application of PRF onto the bowel, however, dramatically decreased the local complications and significantly increased the anastomosis bursting pressures (p < 0.01). Histologic evaluation of the anastomoses showed almost complete healing in all animals. The mean histologic scores of the animals were not different between the groups. CONCLUSION PRF has a beneficial effect on the intestinal healing process by prevention of local complications and increases the tensile strain of the anastomosis. This effect was more prominent, particularly when healing is disrupted. Therefore, we conclude that PRF could be an alternative treatment option to prevent anastomotic complications for elderly, co-morbid and emergency patients.
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Affiliation(s)
- Necdet Özçay
- Department of General Surgery, Near East University, Nicosia, Cyprus
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Mendes BB, Gómez-Florit M, Babo PS, Domingues RM, Reis RL, Gomes ME. Blood derivatives awaken in regenerative medicine strategies to modulate wound healing. Adv Drug Deliv Rev 2018; 129:376-393. [PMID: 29288732 DOI: 10.1016/j.addr.2017.12.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/04/2017] [Accepted: 12/22/2017] [Indexed: 02/06/2023]
Abstract
Blood components play key roles in the modulation of the wound healing process and, together with the provisional fibrin matrix ability to selectively bind bioactive molecules and control its spatial-temporal presentation, define the complex microenvironment that characterize this biological process. As a biomimetic approach, the use of blood derivatives in regenerative strategies has awakened as a source of multiple therapeutic biomolecules. Nevertheless, and despite their clinical relevance, blood derivatives have been showing inconsistent therapeutic results due to several factors, including proper control over their delivery mechanisms. Herein, we highlight recent trends on the use biomaterials to protect, sequester and deliver these pools of biomolecules in tissue engineering and regenerative medicine approaches. Particular emphasis is given to strategies that enable to control their spatiotemporal delivery and improve the selectivity of presentation profiles of the biomolecules derived from blood derivatives rich in platelets. Finally, we discussed possible directions for biomaterials design to potentiate the aimed regenerative effects of blood derivatives and achieve efficient therapies.
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Yu P, Zhai Z, Jin X, Yang X, Qi Z. Clinical Application of Platelet-Rich Fibrin in Plastic and Reconstructive Surgery: A Systematic Review. Aesthetic Plast Surg 2018; 42:511-519. [PMID: 29396591 DOI: 10.1007/s00266-018-1087-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 01/14/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Platelet-rich fibrin (PRF) has been applied in the clinical field for more than a decade, but largely in oral surgery and implant dentistry. Its utilization in plastic and reconstructive surgery is limited and lacking a comprehensive review. Hence, this article focuses on the various clinical applications of PRF pertaining to the plastic and reconstructive field through a systematic review. METHODS In this review, articles describing the clinical application of PRF in plastic and reconstructive surgery were screened using predetermined inclusion and exclusion criteria. The articles were summarized and divided into groups based on the utilization of PRF. The effects and complications of PRF were analyzed and concluded. RESULTS Among the 634 articles searched, 7 articles describing 151 cases are eligible. PRF was applied on 116 (76.8%) wounds to facilitate tissue healing, and the complete wound closure rate was 91.4% (106/116). Otherwise, PRF was applied in 10 (6.6%) cases of zygomaticomaxillary fracture to reconstruct orbital floor defects and in 25 (16.6%) cases of facial autologous fat grafts to increase the fat retention rate successfully. There is no report of PRF-related complications. CONCLUSIONS PRF could facilitate wound healing, including the healing of soft tissues and bony tissues, and facilitate fat survival rate. Further studies are needed to test the mechanism of PRF and expand its scope of application in plastic and reconstructive surgery. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Kubesch A, Barbeck M, Al-Maawi S, Orlowska A, Booms PF, Sader RA, Miron RJ, Kirkpatrick C, Choukroun J, Ghanaati S. A low-speed centrifugation concept leads to cell accumulation and vascularization of solid platelet-rich fibrin: an experimental study in vivo. Platelets 2018; 30:329-340. [DOI: 10.1080/09537104.2018.1445835] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Alica Kubesch
- Frankfurt Orofacial Regenerative Medicine (FORM) -Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt Goethe University, Frankfurt am Main, Germany
| | - Mike Barbeck
- Frankfurt Orofacial Regenerative Medicine (FORM) -Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt Goethe University, Frankfurt am Main, Germany
| | - Sarah Al-Maawi
- Frankfurt Orofacial Regenerative Medicine (FORM) -Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt Goethe University, Frankfurt am Main, Germany
| | - Anna Orlowska
- Frankfurt Orofacial Regenerative Medicine (FORM) -Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt Goethe University, Frankfurt am Main, Germany
| | - Patrick F. Booms
- Frankfurt Orofacial Regenerative Medicine (FORM) -Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt Goethe University, Frankfurt am Main, Germany
| | - Robert A. Sader
- Frankfurt Orofacial Regenerative Medicine (FORM) -Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt Goethe University, Frankfurt am Main, Germany
| | - Richard J. Miron
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Charles.J. Kirkpatrick
- Frankfurt Orofacial Regenerative Medicine (FORM) -Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt Goethe University, Frankfurt am Main, Germany
| | - Joseph Choukroun
- Frankfurt Orofacial Regenerative Medicine (FORM) -Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt Goethe University, Frankfurt am Main, Germany
- Private practice, Pain Therapy Center, Nice, France
| | - Shahram Ghanaati
- Frankfurt Orofacial Regenerative Medicine (FORM) -Lab, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt Goethe University, Frankfurt am Main, Germany
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Liu C, Hao Y, Huang J, Li H, Yang Z, Zeng Y, Liu J, Li R. Ghrelin accelerates wound healing in combined radiation and wound injury in mice. Exp Dermatol 2018; 26:186-193. [PMID: 27676309 DOI: 10.1111/exd.13224] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2016] [Indexed: 12/11/2022]
Abstract
Impaired wound healing caused by radiation happens frequently in clinical practice, and the exact mechanisms remain partly unclear. Various countermeasures have been taken to tackle with this issue. Ghrelin was considered as a potent endogenous growth hormone-releasing peptide, and its role in enhancing wound repair and regeneration was firstly investigated in whole-body irradiated (γ-ray) mice in this study. Collagen deposition and neovascularization were mostly discussed. The results demonstrated that ghrelin administration promoted cutaneous wound healing in irradiated mice, followed with reduced average wound closure time, increased spleen index (SI) and improved haematopoiesis. After isolation and analysis of granulation tissues in combined radiation and wound injury (CRWI) mice treated with and without ghrelin, a phenomenon of increased DNA, hexosamine, nitrate and nitrite synthesis, elevated collagen content and enhanced neovascularization was observed after ghrelin treatment. Western blotting indicated that ghrelin also increased the expression of vascular endothelial growth factor (VEGF) and transforming growth factor-β (TGF-β), both responsible for wound healing. However, previous administration of growth hormone secretagogue receptor 1a (GHS-R1a) blocker blunted these therapeutic effects of ghrelin on CRWI mice. Our results identify ghrelin as a novel peptide that could be used for radiation-induced impaired wound healing.
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Affiliation(s)
- Cong Liu
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Yuhui Hao
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Jiawei Huang
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Hong Li
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Zhangyou Yang
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Yiping Zeng
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Jing Liu
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Rong Li
- Institute of Combined Injury, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Third Military Medical University, Chongqing, China
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Affiliation(s)
- Julia Etulain
- Laboratory of Experimental Thrombosis, Institute of Experimental Medicine-CONICET, National Academy of Medicine, Buenos Aires, Argentina
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Nishimoto S, Fujita K, Fujiwara T, Sotsuka Y, Tonooka M, Ishise H, Kawai K, Kakibuchi M. An Attempt to Make Platelet Rich Fibrin from Bone Marrow Aspirate. J Clin Diagn Res 2017; 11:PC04-PC07. [PMID: 28969191 DOI: 10.7860/jcdr/2017/27006.10380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 04/10/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Platelet Rich Fibrin (PRF) was developed as a new generation of platelet concentration from peripheral blood. Method to make PRF is simple. It is easy to handle with its moderate firmness. Histologically, platelets and nucleated cells are packed along the yellow-red border. Bone marrow aspirate contains bone marrow cells that potentially work for tissue regeneration, and platelets which contain growth factors. The specific gravities of them are comparable. It implies that, if it is possible to make PRF from bone marrow aspirate, then high concentration of platelets and bone marrow cells can be obtained simultaneously by taking out yellow-red interface of it. AIM To find out a method to make PRF from bone marrow aspirate. MATERIALS AND METHODS Iliac crest of rabbits were punctured and aspirated with or without anti-coagulant, under general anaesthesia. The bone marrow aspirate was centrifuged in glass tubes. For the bone marrow aspirate taken with anti-coagulant, calcium chloride was added just before centrifugation. Products were taken out and observed grossly. The products were fixed with formaldehyde and observed histologically. RESULTS Coagulated gels with two-toned colour were obtained by all methods. In the gels without anti-coagulant, interfaces between two colours were obscure. Histologically, platelets and nucleated cells scattered as clusters. Filtering caused haemolysis and reduced the yield of the product. With the aspirate taken with anti-coagulant, platelets and nucleated cells formed a band along the interface. CONCLUSION PRF can be made from bone marrow aspirate by adding anti-coagulant in aspiration and reversed with calcium chloride just before centrifugation.
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Affiliation(s)
- Soh Nishimoto
- Professor, Department of Plastic Surgery, Hyogo College of Medicine Nishinomiya, Hyogo, Japan
| | - Kazutoshi Fujita
- Assistant, Department of Plastic Surgery, Hyogo College of Medicine Nishinomiya, Hyogo, Japan
| | - Toshihiro Fujiwara
- Lecturer, Department of Plastic Surgery, Hyogo College of Medicine Nishinomiya, Hyogo, Japan
| | - Yohei Sotsuka
- Lecturer, Department of Plastic Surgery, Hyogo College of Medicine Nishinomiya, Hyogo, Japan
| | - Maki Tonooka
- Assistant, Department of Plastic Surgery, Hyogo College of Medicine Nishinomiya, Hyogo, Japan
| | - Hisako Ishise
- Assistant, Department of Plastic Surgery, Hyogo College of Medicine Nishinomiya, Hyogo, Japan
| | - Kenichiro Kawai
- Associate Professor, Department of Plastic Surgery, Hyogo College of Medicine Nishinomiya, Hyogo, Japan
| | - Masao Kakibuchi
- Professor, Department of Plastic Surgery, Hyogo College of Medicine Nishinomiya, Hyogo, Japan
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Evidence-Based Medicine: Options for Dupuytren's Contracture: Incise, Excise, and Dissolve. Plast Reconstr Surg 2017; 139:240e-255e. [PMID: 28027258 DOI: 10.1097/prs.0000000000002857] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
LEARNING OBJECTIVES After studying this article, the participant should be able to: 1. Understand updates in the basic science, epidemiology, and treatment of Dupuytren's disease. 2. Understand treatment with needle aponeurotomy, collagenase, and fasciectomy. 3. Understand advanced needle techniques for Dupuytren's contracture. 4. Understand the safety and effectiveness of a new treatment, collagenase. SUMMARY The literature on Dupuytren's disease encompasses many specialties. Its treatment is generally by perforating, excising, or dissolving the affected tissues. This article reviews the changing understanding of this disease and treatment options.
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Platelet Rich Fibrin “PRF” and Regenerative Medicine: ‘The Low-Speed Concept’. STEM CELL BIOLOGY AND REGENERATIVE MEDICINE 2017. [DOI: 10.1007/978-3-319-55645-1_2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Miron RJ, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-Rich Fibrin and Soft Tissue Wound Healing: A Systematic Review. TISSUE ENGINEERING PART B-REVIEWS 2016; 23:83-99. [PMID: 27672729 DOI: 10.1089/ten.teb.2016.0233] [Citation(s) in RCA: 225] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The growing multidisciplinary field of tissue engineering aims at predictably regenerating, enhancing, or replacing damaged or missing tissues for a variety of conditions caused by trauma, disease, and old age. One area of research that has gained tremendous awareness in recent years is that of platelet-rich fibrin (PRF), which has been utilized across a wide variety of medical fields for the regeneration of soft tissues. This systematic review gathered all the currently available in vitro, in vivo, and clinical literature utilizing PRF for soft tissue regeneration, augmentation, and/or wound healing. In total, 164 publications met the original search criteria, with a total of 48 publications meeting inclusion criteria (kappa score = 94%). These studies were divided into 7 in vitro, 11 in vivo, and 31 clinical studies. In summary, 6 out of 7 (85.7%) and 11 out of 11 (100%) of the in vitro and in vivo studies, respectively, demonstrated a statistically significant advantage for combining PRF to their regenerative therapies. Out of the remaining 31 clinical studies, a total of 8 reported the effects of PRF in a randomized clinical trial, with 5 additional studies (13 total) reporting appropriate controls. In those clinical studies, 9 out of the 13 studies (69.2%) demonstrated a statistically relevant positive outcome for the primary endpoints measured. In total, 18 studies (58% of clinical studies) reported positive wound-healing events associated with the use of PRF, despite using controls. Furthermore, 27 of the 31 clinical studies (87%) supported the use of PRF for soft tissue regeneration and wound healing for a variety of procedures in medicine and dentistry. In conclusion, the results from the present systematic review highlight the positive effects of PRF on wound healing after regenerative therapy for the management of various soft tissue defects found in medicine and dentistry.
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Affiliation(s)
- Richard J Miron
- 1 Department of Periodontology, Nova Southeastern University , Fort Lauderdale, Florida
| | - Masako Fujioka-Kobayashi
- 1 Department of Periodontology, Nova Southeastern University , Fort Lauderdale, Florida.,2 Cranio-Maxillofacial Surgery, Bern University Hospital , Inselspital, Bern, Switzerland .,3 Department of Oral Surgery, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School , Tokushima, Japan
| | - Mark Bishara
- 4 West Bowmanville Family Dental , Ontario, Canada
| | - Yufeng Zhang
- 5 Department of Oral Implantology, University of Wuhan , Wuhan, China
| | - Maria Hernandez
- 1 Department of Periodontology, Nova Southeastern University , Fort Lauderdale, Florida
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Temmerman A, Vandessel J, Castro A, Jacobs R, Teughels W, Pinto N, Quirynen M. The use of leucocyte and platelet-rich fibrin in socket management and ridge preservation: a split-mouth, randomized, controlled clinical trial. J Clin Periodontol 2016; 43:990-999. [PMID: 27509214 DOI: 10.1111/jcpe.12612] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2016] [Indexed: 12/30/2022]
Abstract
AIM To investigate the influence of the use L-PRF as a socket filling material and its ridge preservation properties. MATERIALS AND METHODS Twenty-two patients in need of single bilateral and closely symmetrical tooth extractions in the maxilla or mandible were included in a split-mouth RCT. Treatments were randomly assigned (L-PRF socket filling versus natural healing). CBCT scans were obtained after tooth extraction and three months. Scans were evaluated by superimposition using the original DICOM data. Mean ridge width differences between timepoints were measured at three levels below the crest on both the buccal and lingual sides (crest -1 mm (primary outcome variable), -3 mm and -5 mm). RESULTS Mean vertical height changes at the buccal were -1.5 mm (±1.3) for control sites and 0.5 mm (±2.3) for test sites (p < 0.005). At the buccal side, control sites values were, respectively, -2.1 (±2.5), -0.3 mm (±0.3) (p < 0.005) and -0.1 mm (±0.0), and test sites values were, respectively, -0.6 mm (±2.2) (p < 0.005), -0.1 mm (±0.3) and 0.0 mm (±0.1). Significant differences (p < 0.005) were found for total width reduction between test (-22.84%) and control sites (-51.92%) at 1 mm below crest level. Significant differences were found for socket fill (visible mineralized bone) between test (94.7%) and control sites (63.3%). CONCLUSION The use of L-PRF as a socket filling material to achieve preservation of horizontal and vertical ridge dimension at three months after tooth extraction is beneficial.
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Affiliation(s)
- Andy Temmerman
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals, KU Leuven, Leuven, Belgium.
| | - Jeroen Vandessel
- OMFS-Impath Research Group, Department of Oral and Maxillofacial Surgery, University Hospitals, KU Leuven, Leuven, Belgium
| | - Ana Castro
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-Impath Research Group, Department of Oral and Maxillofacial Surgery, University Hospitals, KU Leuven, Leuven, Belgium
| | - Wim Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Nelson Pinto
- Department of Oral Implantology, University De Los Andes, Santiago, Chile
| | - Marc Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
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Bilginaylar K, Uyanik L. Evaluation of the effects of platelet-rich fibrin and piezosurgery on outcomes after removal of ımpacted mandibular third molars. Br J Oral Maxillofac Surg 2016; 54:629-33. [DOI: 10.1016/j.bjoms.2016.03.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 03/18/2016] [Indexed: 10/22/2022]
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Soldatova L, Campbell RG, Elkhatib AH, Schmidt TW, Pinto NR, Pinto JM, Prevedello DM, Ditzel Filho LF, Otto BA, Carrau RL. Role of Leukocyte-Platelet-Rich Fibrin in Endoscopic Endonasal Skull Base Surgery Defect Reconstruction. J Neurol Surg B Skull Base 2016; 78:59-62. [PMID: 28180044 DOI: 10.1055/s-0036-1584894] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 05/25/2016] [Indexed: 12/30/2022] Open
Abstract
Objective Advancements in endoscopic endonasal approaches have increased the extent and complexity of skull base resections, in turn demanding the development of novel techniques for skull base defect reconstruction. The objective of this pilot study was to investigate the effect of leukocyte-platelet-rich fibrin (L-PRF) on the postoperative healing after endoscopic skull base surgery. Methods Between January and May of 2015, 47 patients underwent endoscopic endonasal resection of sellar, parasellar, and suprasellar lesions with the application of L-PRF membranes during the skull base reconstruction at two surgical centers. Early postoperative records were retrospectively reviewed. Results We found that 21 days following the surgery, 17/41 patients (42%) demonstrated improvement in the crusting score as compared with their 7 day postoperative examination. Ten of these patients (23%) showed no crusting. Fourteen (34%) patients had no change in the crusting score. Six patient records were incomplete. A total of 4/47 cases (8.5%) had postoperative cerebrospinal fluid leak requiring surgical repair. Conclusion This study demonstrates the potential utility of L-PRF membranes for skull base defect reconstruction. Future studies will be conducted to better assess the role of L-PRF in endoscopic skull base surgery.
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Affiliation(s)
- Liuba Soldatova
- Department of Otolaryngology - Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Raewyn G Campbell
- Department of Otolaryngology - Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Ahmad H Elkhatib
- Department of Otolaryngology - Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Thomas W Schmidt
- Department of Otolaryngology - Head & Neck Surgery, Universidad de Concepción, Concepcion, Chile
| | - Nelson R Pinto
- Graduate School of Periodontics and Implant Dentistry, Research Center for Regenerative Medicine and Tissue Engineering, University of the Andes-Chile, Concepcion, Chile
| | - Jaime M Pinto
- Department of Neurosurgery, Universidad de Concepción, Concepcion, Chile
| | - Daniel M Prevedello
- Department of Otolaryngology - Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States; Department of Neurologic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Leo F Ditzel Filho
- Department of Otolaryngology - Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Bradley A Otto
- Department of Otolaryngology - Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States; Department of Neurologic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Ricardo L Carrau
- Department of Otolaryngology - Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States; Department of Neurologic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
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Rodrigues JN, Becker GW, Ball C, Zhang W, Giele H, Hobby J, Pratt AL, Davis T. Surgery for Dupuytren's contracture of the fingers. Cochrane Database Syst Rev 2015; 2015:CD010143. [PMID: 26648251 PMCID: PMC6464957 DOI: 10.1002/14651858.cd010143.pub2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Dupuytren's disease is a benign fibroproliferative disorder that causes the fingers to be drawn into the palm via formation of new tissue under the glabrous skin of the hand. This disorder causes functional limitations, but it can be treated through a variety of surgical techniques. As a chronic condition, it tends to recur. OBJECTIVES To assess the benefits and harms of different surgical procedures for treatment of Dupuytren's contracture of the index, middle, ring and little fingers. SEARCH METHODS We initially searched the following databases on 17 September 2012, then re-searched them on 10 March 2014 and on 20 May 2015: the Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library, the British Nursing Index and Archive (BNI), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, the Latin American Caribbean Health Sciences Literature (LILACS), Ovid MEDLINE, Ovid MEDLINE-In-Process and Other Non-Indexed Citations, ProQuest (ABI/INFORM Global and Dissertations & Theses), the Institute for Scientific Information (ISI) Web of Science and clinicaltrials.gov. We reviewed the reference lists of short-listed articles to identify additional suitable studies. SELECTION CRITERIA We included randomised clinical trials and controlled clinical trials in which groups received surgical intervention for Dupuytren's disease of the index, middle, ring or little finger versus control, or versus another intervention (surgical or otherwise). We excluded the thumb, as cords form on the radial aspect of the thumb and thus are not readily accessible in terms of angular deformity. Furthermore, thumb disease is rare. DATA COLLECTION AND ANALYSIS A minimum of two review authors independently reviewed search results to select studies for inclusion by using pre-specified criteria, assessed risk of bias of included studies and extracted data from included studies.We grouped outcomes into the following categories: (1) hand function, (2) other patient-reported outcomes (e.g. satisfaction, pain), (3) early objective outcomes (e.g. correction of angular deformity), (4) late objective outcomes (e.g. recurrence) and (5) adverse effects. MAIN RESULTS We included 14 articles describing 13 studies, comprising 11 single-centre studies and two multi-centre studies. These studies involved 944 hands of 940 participants; of these, 93 participants were reported twice in separate articles describing early and late outcomes of one trial. Three papers reported the outcomes of two trials comparing different procedures. One trial compared needle fasciotomy versus fasciectomy (125 hands, 121 participants), and the other compared interposition firebreak skin grafting versus z-plasty closure of fasciectomy (79 participants). The other 11 studies reported trials of technical refinements of procedures or rehabilitation adjuncts. Of these, three investigated effects of postoperative splinting on surgical outcomes.Ten studies (11 articles) were randomised controlled trials (RCTs) of varying methodological quality; one was a controlled clinical trial. Trial design was unclear in two studies awaiting classification. All trials had high or unclear risk of at least one type of bias. High risks of performance and detection bias were particularly common. We downgraded the quality of evidence (Grades of Recommendation, Assessment, Development and Evaluation - GRADE) of outcomes to low because of concerns about risk of bias and imprecision.Outcomes measured varied between studies. Five articles assessed recurrence; two defined this as reappearance of palpable disease and two as deterioration in angular deformity; one did not explicitly define recurrence.Hand function on the Disabilities of the Arm, Shoulder and Hand (DASH) Scale (scores between 0 and 100, with higher scores indicating greater impairment) was 5 points lower after needle fasciotomy than after fasciectomy at five weeks. Patient satisfaction was better after fasciotomy at six weeks, but the magnitude of effect was not specified. Fasciectomy improved contractures more effectively in severe disease: Mean percentage reduction in total passive extension deficit at six weeks for Tubiana grades I and II was 11% lower after needle fasciotomy than after fasciectomy, whereas for grades III and IV disease, it was 29% and 32% lower.Paraesthesia (defined as subjective tingling sensation without objective evidence of altered sensation) was more common than needle fasciotomy at one week after fasciectomy (228/1000 vs 67/1000), but reporting of complications was variable.By five years, satisfaction (on a scale from 0 to 10, with higher scores showing greater satisfaction) was 2.1/10 points higher in the fasciectomy group than in the fasciotomy group, and recurrence was greater after fasciotomy (849/1000 vs 209/1000). Firebreak skin grafting did not improve outcomes more than fasciectomy alone, although this procedure took longer to perform.One trial investigated four weeks of day and night splinting followed by two months of night splinting after surgery. The other two trials investigated three months of night splinting after surgery, but participants in 'no splint' groups with early deterioration at one week were issued a splint for use. All three studies demonstrated no benefit from splinting. The two trials investigating postoperative night splinting were suitable for meta-analysis, which demonstrated no benefit from splinting: Mean DASH score in the splint groups was 1.15 points lower (95% confidence interval (CI) -2.32 to 4.62) than in the no splint groups. Mean total active extension in the splint groups was 2.21 degrees greater (95% CI -3.59 to 8.01 degrees) than in the no splint groups. Mean total active flexion in the splint groups was 8.42 degrees less (95% CI 1.78 to 15.07 degrees) than in the no splint groups. AUTHORS' CONCLUSIONS Currently, insufficient evidence is available to show the relative superiority of different surgical procedures (needle fasciotomy vs fasciectomy, or interposition firebreak skin grafting vs z-plasty closure of fasciectomy). Low-quality evidence suggests that postoperative splinting may not improve outcomes and may impair outcomes by reducing active flexion. Further trials on this topic are urgently required.
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Affiliation(s)
- Jeremy N Rodrigues
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)Botnar Research Centre, Windmill RoadOxfordOxfordshireUKOX3 7LD
| | - Giles W Becker
- University of Arizona Medical CenterDepartment of Surgery1501 N Campbell AvenueTucsonArizonaUSA85724
| | - Cathy Ball
- University of OxfordKennedy Institute of RheumatologyRoosevelt DriveHeadingtonOxfordUKOX3 7FY
| | - Weiya Zhang
- The University of NottinghamDivision of Academic RheumatologyClinical Sciences BuildingCity HospitalNottinghamEnglandUKNG5 1PB
| | - Henk Giele
- Oxford University HospitalsDepartment of Plastic, Reconstructive and Hand SurgeryOxfordOxfordshireUKOX3 9DU
| | - Jonathan Hobby
- North Hampshire HospitalTrauma and Orthopaedic SurgeryAldermaston RoadBasingstokeHampshireUKRG24 9NA
| | - Anna L Pratt
- Brunel UniversityCollege of Health and Life SciencesKingston LaneUxbridgeMiddlesexUKUB8 3PH
| | - Tim Davis
- Nottingham University HospitalsTrauma and OrthopaedicsQueens Medical CampusNottinghamUKNG7 2UH
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Sclafani AP, Azzi J. Platelet Preparations for Use in Facial Rejuvenation and Wound Healing: A Critical Review of Current Literature. Aesthetic Plast Surg 2015; 39:495-505. [PMID: 26044392 DOI: 10.1007/s00266-015-0504-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 05/12/2015] [Indexed: 12/13/2022]
Abstract
In facial plastic surgery, the potential for direct delivery of growth factors from platelet preparations has been of particular interest for use in facial rejuvenation, recovery after facial surgery, and wound healing. A literature search was conducted through PubMed for the terms PRP, PRFM, platelet-rich plasma, platelet-rich fibrin matrix, platelet preparations, platelet therapy, growth factors, platelet facial, platelet facial rejuvenation, platelet wound healing, platelet plastic surgery. Articles pertaining to the use of platelet preparations in facial surgery and wound healing in plastic surgery after 2001 were included. Thirteen in vitro studies showed use of platelet-rich plasma (PRP) and platelet-rich fibrin matrix (PRFM) had a significant effect on cellular activity. Twenty-four out of 28 animal studies exhibited favorable results with use of a platelet preparation, including five of six studies that showed enhanced fat graft survival with addition of a platelet preparation. Twenty-three case series and clinical trials were identified, only two of which showed no differences. Twenty-one reported favorable results with use of various platelet preparations. A total of 47 studies used PRP, four studies evaluated Leukocyte-rich PRP, and fourteen studies used PRFM. The vast majority of studies examined show a significant and measurable effect on cellular changes, wound healing, and facial esthetic outcomes with use of platelet preparations, both topical and injectable. One must also consider possible publication bias against null results that may have had an influence on the data that were available for review. However, the preponderance of studies suggests that platelet preparations might represent an as-of-yet untapped adjunct in facial plastic surgery.
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Affiliation(s)
- Anthony P Sclafani
- Department of Otolaryngology, Weill Cornell Medical College, 1305 York Avenue, 5th Floor, New York, NY, 10021, USA,
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Uyanık LO, Bilginaylar K, Etikan İ. Effects of platelet-rich fibrin and piezosurgery on impacted mandibular third molar surgery outcomes. Head Face Med 2015. [PMID: 26209242 PMCID: PMC4514981 DOI: 10.1186/s13005-015-0081-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Introduction The aim of this study was the comparision of postoperative outcomes in impacted mandibular third molars that were treated using either platelet-rich fibrin (PRF), a combination of PRF and piezosurgery, or conventional rotatory osteotomy. Patient and methods The study included 20 patients; 40 extractions of impacted mandibular third molars were performed. Patients were divided into two main groups. In group A (n = 20), traditional surgery was performed on one side (Group 1, n = 10); traditional surgery was performed, and PRF was administered to the extracted socket on the other side of same patient (Group 2, n = 10). In group B (n = 20), on one side, piezosurgery was used for osteotomy, and PRF was administered (Group 3, n = 10); on the other side of same patient, traditional surgery was performed (Group 4, n = 10). Parameters assessed at baseline for each patient included pain, the number of analgesics taken, trismus, and cheek swelling. These variables were also assessed on postoperative days 1, 2, 3, and 7. Results Statistical analysis revealed a significant reduction in postoperative pain (sum of 1st, 2nd, 3rd and 7th days) and trismus (on postoperative day 1) in group 2 (traditional surgery + PRF group), and in postoperative pain, the number of analgesics taken (sum of 1st, 2nd,3rd and 7th days) and trismus (on postoperative day 1) in group 3 (piezosurgery + PRF group) compared to groups 1 and 4 (traditional surgery groups), (p ≤ 0.05). However, swelling on postoperative days 1, 3, and 7 did not differ among the groups (p > 0.05). Only difference was on second day between groups 1–4 and 2–4 (p ≤ 0.05). Conclusions The results of our study have shown that the use of PRF with traditional surgery and PRF combined with piezosurgery significantly reduced pain during the postoperative period. In addition, PRF in combination with piezosurgery significantly decreased the number of analgesics taken. Both operations also significantly decreased trismus 24 h after the surgery. As a result of this study, PRF and combination use of PRF and piezosurgery have positive effects in reducing postoperative outcomes after impacted third molar surgery.
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Affiliation(s)
- Lokman Onur Uyanık
- Department of Oral and Maxillofacial Surgery, Near East University Faculty of Dentistry, Nicosia, Cyprus.
| | - Kani Bilginaylar
- Department of Oral and Maxillofacial Surgery, Near East University Faculty of Dentistry, Nicosia, Cyprus.
| | - İlker Etikan
- Department of Biostatistics, Near East University Faculty of Medicine, Nicosia, Cyprus.
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Enhancement of the repair of dog alveolar cleft by an autologous iliac bone, bone marrow-derived mesenchymal stem cell, and platelet-rich fibrin mixture. Plast Reconstr Surg 2015; 135:1405-1412. [PMID: 25835246 DOI: 10.1097/prs.0000000000001166] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Autologous bone graft has been regarded as the criterion standard for the repair of alveolar cleft. However, the most prominent issue in alveolar cleft treatment is the high absorption rate of the bone graft. The authors' objective was to investigate the effects of an autologous iliac bone, bone marrow-derived mesenchymal stem cell, and platelet-rich fibrin mixture on the repair of dog alveolar cleft. METHODS Twenty beagle dogs with unilateral alveolar clefts created by surgery were divided randomly into four groups: group A underwent repair with an autologous iliac bone, bone marrow-derived mesenchymal stem cell, and platelet-rich fibrin mixture; group B underwent repair with autologous iliac bone and bone marrow-derived mesenchymal stem cells; group C underwent repair with autologous iliac bone and platelet-rich fibrin; and group D underwent repair with autologous iliac bone as the control. One day and 6 months after transplantation, the transplant volumes and bone mineral density were assessed by quantitative computed tomography. All of the transplants were harvested for hematoxylin and eosin staining 6 months later. RESULTS Bone marrow-derived mesenchymal stem cells and platelet-rich fibrin transplants formed the greatest amounts of new bone among the four groups. The new bone formed an extensive union with the underlying maxilla in groups A, B, and C. Transplants with the bone marrow-derived mesenchymal stem cells, platelet-rich fibrin, and their mixture retained the majority of their initial volume, whereas the transplants in the control group showed the highest absorption rate. Bone mineral density of transplants with the bone marrow-derived mesenchymal stem cells, platelet-rich fibrin, and their mixture 6 months later was significantly higher than in the control group (p < 0.05), and was the highest in bone marrow-derived mesenchymal stem cells and platelet-rich fibrin mixed transplants. Hematoxylin and eosin staining showed that the structure of new bones formed the best in group A. CONCLUSION Both bone marrow-derived mesenchymal stem cells and platelet-rich fibrin are capable of improving the repair of dog alveolar cleft, and the mixture of them is more potent than each one of them used singly for enhancing new bone regeneration.
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Growth Factor Measurement and Histological Analysis in Platelet Rich Fibrin: A Pilot Study. J Maxillofac Oral Surg 2015; 14:907-13. [PMID: 26604462 DOI: 10.1007/s12663-015-0768-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 02/28/2015] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare growth factor amount contained in platelet rich fibrin (PRF) and compare with that in platelet rich plasma (PRP), and in whole blood. And also to investigate distribution of growth factors and cellular components in PRF. MATERIALS AND METHODS PRF and PRP were obtained from the same sample of peripheral blood. Extraction of proteins were done with lysis buffer, accompanied by freeze and thaw procedures. Concentration of two representative growth factors in platelets: platelet derived growth factor (PDGF) and transforming growth factor beta (TGF-β), were measured with enzyme-linked immunosorbent assay (ELISA). PRF was cut into three parts: (top, middle and bottom), and growth factor concentration was measured respectively. Paraffin embedded section of PRF was observed with Giemsa stain. Immuno-histochemical analysis with anti-PDGF and anti-TGF-β antibodies was also conducted. RESULTS The growth factor levels in PRF was higher than in peripheral blood and comparable to those in PRP. Growth factor levels in bottom part of PRF was much higher than in top and middle part. Microscopically, platelets and mono-nucleated cells were concentrated just above the yellow-red interface. Poly-nucleated cells were concentrated below the interface. CONCLUSION The growth factors were surely concentrated in PRF. This result can support basis of good clinical outcomes. For effective application of PRF, the knowledge that growth factors and cells are not equally distributed in PRF should be utilized.
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De Pascale MR, Sommese L, Casamassimi A, Napoli C. Platelet derivatives in regenerative medicine: an update. Transfus Med Rev 2015; 29:52-61. [PMID: 25544600 DOI: 10.1016/j.tmrv.2014.11.001] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 11/03/2014] [Accepted: 11/09/2014] [Indexed: 12/26/2022]
Abstract
Prior preclinical and clinical studies support the use of platelet-derived products for the treatment of soft and hard tissue lesions. These regenerative effects are controlled by autocrine and paracrine biomolecules including growth factors and cytokines contained in platelet alpha granules. Each growth factor is involved in a phase of the healing process, such as inflammation, collagen synthesis, tissue granulation, and angiogenesis collectively promoting tissue restitution. Platelet derivatives have been prepared as platelet-rich plasma, platelet gel, platelet-rich fibrin, and platelet eye drops. These products vary in their structure, growth factors, composition, and cytokine concentrations. Here, we review the current use of platelet-derived biological products focusing on the rationale for their use and the main requirements for their preparation. Variation in the apparent therapeutic efficacy may have resulted from a lack of reproducible, standardized protocols for preparation. Despite several individual studies showing favorable treatment effects, some randomized controlled trials as well as meta-analyses have found no constant clinical benefit from the application of platelet-derived products for prevention of tissue lesions. Recently, 3 published studies in dentistry showed an improvement in bone density. Seven published studies showed positive results in joint regeneration. Five published studies demonstrated an improvement in the wound healing, and an improvement of eye epithelial healing was observed in 2 reports. Currently, at least 14 ongoing clinical trials in phase 3 or 4 have been designed with large groups of treated patients (n > 100). Because the rationale of the therapy with platelet-derived compounds is still debated, a definitive insight can be acquired only when these large randomized trials will be completed.
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Affiliation(s)
- Maria Rosaria De Pascale
- UOC Immunohematology, Transfusion Medicine and Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Naples, Italy
| | - Linda Sommese
- UOC Immunohematology, Transfusion Medicine and Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Naples, Italy
| | - Amelia Casamassimi
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy.
| | - Claudio Napoli
- UOC Immunohematology, Transfusion Medicine and Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Naples, Italy; Institute of Diagnostic and Nuclear Development, IRCCS, Naples, Italy
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Li X, Xu CP, Hou YL, Song JQ, Cui Z, Yu B. Are platelet concentrates an ideal biomaterial for arthroscopic rotator cuff repair? A meta-analysis of randomized controlled trials. Arthroscopy 2014; 30:1483-90. [PMID: 24913394 DOI: 10.1016/j.arthro.2014.03.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 03/21/2014] [Accepted: 03/21/2014] [Indexed: 02/08/2023]
Abstract
PURPOSE The present study aims to conduct a meta-analysis of Level I evidence studies to investigate the efficacy of concomitant platelet concentrate (PC) used in arthroscopic rotator cuff repair. METHODS We systematically searched electronic databases to identify randomized controlled trials (RCTs) evaluating the role of PC augmentation in arthroscopic rotator cuff repairs for patients with full-thickness tears. The search strategy followed the requirements in the Cochrane Library Handbook. The primary outcome was retearing of the rotator cuff. Functional outcomes were analyzed in terms of Constant score, specific Constant pain score, University of California, Los Angeles (UCLA) shoulder score, Simple Shoulder Test (SST) score, and American Shoulder and Elbow Surgeons (ASES) score. RESULTS Seven studies with a total of 417 patients available at the latest follow-up reporting data about retears were analyzed in this meta-analysis. However, 4 studies with Constant scores (n = 237), 3 studies with UCLA scores (n = 168), 2 studies with Constant pain scores (n = 164), 2 studies with ASES scores (n = 101), and 2 studies with SST scores (n = 121) were analyzed. The retear rates and functional scores showed that there was no significant efficacy of PC application in arthroscopic rotator cuff repairs. CONCLUSIONS This meta-analysis of high-level evidence suggests that PCs have no benefit regarding retear rate and overall clinical outcomes for the arthroscopic repair of full-thickness rotator cuff tears. LEVEL OF EVIDENCE Level II, meta-analysis of randomized controlled trials.
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Affiliation(s)
- Xue Li
- Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China; Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chang-Peng Xu
- Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yi-Long Hou
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jin-Qi Song
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhuang Cui
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Bin Yu
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
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Platelet rich fibrin versus Hemcon dental dressing following dental extraction in patients under anticoagulant therapy. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.tdj.2014.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Chen Y, Niu Z, Xue Y, Yuan F, Fu Y, Bai N. Improvement in the repair of defects in maxillofacial soft tissue in irradiated minipigs by a mixture of adipose-derived stem cells and platelet-rich fibrin. Br J Oral Maxillofac Surg 2014; 52:740-5. [PMID: 24993354 DOI: 10.1016/j.bjoms.2014.06.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 06/09/2014] [Indexed: 01/07/2023]
Abstract
To find out if adipose-derived stem cells (ASC) and platelet-rich fibrin (PRF), alone or combined, had any effect on the repair of maxillofacial soft tissue defects in irradiated minipigs, ASC were isolated, characterised, and expanded. Twenty female minipigs, the right parotid glands of which had been irradiated, were randomly divided into 4 groups of 5 each: those in the first group were injected with both ASC and PRF (combined group), the second group was injected with ASC alone (ASC group), the third group with PRF alone (PRF group), and the fourth group with phosphate buffer saline (PBS) (control group). Six months after the last injection, the size and depth of each defect were assessed, and subcutaneous tissues were harvested, stained with haematoxylin and eosin, and examined immunohistologically and for apoptosis. Expanded cells were successfully isolated and identified. Six months after injection the defects in the 3 treated groups were significantly smaller (p<0.001) and shallower (p<0.001) than those in the control group. Those in the combined group were the smallest and shallowest. Haematoxylin and eosin showed that the 3 treated groups contained more subcutaneous adipose tissue than the control group, and also had significantly greater vascular density (p<0.001) and fewer apoptotic cells (p<0.001). Both ASC and PRF facilitate the repair of defects in maxillofacial soft tissue in irradiated minipigs, and their combined use is more effective than their use as single agents.
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Affiliation(s)
- Yuanzheng Chen
- Department of Burns Surgery, Linyi People's Hospital, Linyi, Shandong 276000, China
| | - Zhanguo Niu
- Department of Burns and Plastic Surgery, Dongguan People's Hospital, Dongguan, Guangdong 523059, China
| | - Yan Xue
- Department of Ultrasonography, Linyi People's Hospital, Linyi, Shandong 276000, China
| | - Fukang Yuan
- Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Yanjie Fu
- Department of Burns Surgery, Linyi People's Hospital, Linyi, Shandong 276000, China
| | - Nan Bai
- Department of Plastic Surgery, Linyi People's Hospital, Linyi, Shandong 276000, China.
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Guinot A, Arnaud A, Azzis O, Habonimana E, Jasienski S, Frémond B. Preliminary experience with the use of an autologous platelet-rich fibrin membrane for urethroplasty coverage in distal hypospadias surgery. J Pediatr Urol 2014; 10:300-5. [PMID: 24325905 DOI: 10.1016/j.jpurol.2013.09.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 09/26/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Platelet-rich fibrin (PRF) has been shown to have structural and biological properties that promote tissue healing. This prospective study evaluated the feasibility, safety, and efficiency of using autologous PRF membrane for urethroplasty coverage in distal hypospadias. MATERIALS AND METHODS We prospectively included 33 patients with distal hypospadias operated on between June 2010 and September 2011. Urethroplasties were performed using the Duplay technique. During surgery, 5-10 ml of patient's blood was collected and immediately centrifuged. A PRF clot was transformed into a dense fibrin membrane with a particular cell content and architecture. This membrane was applied and sutured over the urethroplasty. The perioperative course and complications were recorded. Outcomes were compared with those in a control group of children undergoing the same procedure, but with another mean of coverage. RESULTS With a median follow-up of 8 months (range, 6-18 months), urethral fistula occurred in 2/33 patients. No other complication was noted. No complication related to the blood sampling was reported. There was no statistically significant difference with the control group (p = 0.65). CONCLUSION The PRF patch seems to be a safe and efficient covering technique. Thus, procedure is an additional approach to coverage for hypospadias surgery, and may help to reduce the incidence of postoperative complications when coverage healthy tissue is not available.
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Affiliation(s)
- A Guinot
- Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France.
| | - A Arnaud
- Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France
| | - O Azzis
- Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France
| | - E Habonimana
- Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France
| | - S Jasienski
- Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France
| | - B Frémond
- Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France
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Horii K, Kanayama T, Miyamoto H, Kohgo T, Tsuchimochi T, Shigetomi T, Yokoi M. Platelet-rich fibrin has a healing effect on chemotherapy-induced mucositis in hamsters. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:445-53. [DOI: 10.1016/j.oooo.2013.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 11/30/2013] [Accepted: 12/04/2013] [Indexed: 10/25/2022]
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