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Rojas Mora GX, Sánchez Godoy JA, Heredia Ramirez RA, Fernández Sánchez MJ, Gómez LA. Closure of a Difficult-to-Manage Chronic Pressure Injury with the Use of Autologous Platelet-Rich Plasma (APRP). Int Med Case Rep J 2021; 14:649-656. [PMID: 34588822 PMCID: PMC8472182 DOI: 10.2147/imcrj.s322108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/19/2021] [Indexed: 11/23/2022] Open
Abstract
Pressure injury (PI) corresponds to a skin damage of ischemic aetiology that affects the integrity of the skin and is produced by prolonged pressure or friction between a hard internal and external surface. Treatment can be challenging when there is no resolution with usual care. The use of autologous platelet-rich plasma (APRP) gel arises as a therapeutic possibility in the presence of chronic pressure injuries. The case of a patient with chronic PI who has been treated with APRP is presented, achieving resolution of the lesion.
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Affiliation(s)
- Gina Xihomara Rojas Mora
- Department of Physiological Sciences, School of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Jesús Armando Sánchez Godoy
- Department of Physiological Sciences, School of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Rodrigo Alberto Heredia Ramirez
- Geriatrics Unit, Hospital Universitario San Ignacio, Department of Internal Medicine, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - María José Fernández Sánchez
- Department of Internal Medicine, Hospital Universitario San Ignacio, Department of Physiological Sciences, School of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Lina Andrea Gómez
- Bioscience Department, School of Medicine, Biomedical Research Center (CIBUS), Universidad de La Sabana, Chía, Colombia
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Meira RDO, Braga DNM, Pinheiro LSG, Amorim IFG, Vasconcellos LDS, Alberti LR. Effects of homologous and heterologous rich platelets plasma, compared to poor platelets plasma, on cutaneous healing of rabbits. Acta Cir Bras 2020; 35:e202001006. [PMID: 33237177 PMCID: PMC7709901 DOI: 10.1590/s0102-865020200100000006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose: To evaluate and compare the effects of homologous and heterologous PRP (Platelet-Rich Plasma) on the quality and speed of skin wound healing, compared to Poor Platelet Plasma (PPP). Methods: Twenty-one male adult rabbits were used; two for preparing homologous PRP, with the rest of them separated randomly in three groups, according to the treatment received: PPP - control (n=5), homologous PRP (n=7), heterologous (n=7). Excisional skin wounds were made on the back of the animals, for the application of homologous and heterologous PPP and PRP. At the 14th post-operative day (POD), the animals were subjected to a new wound, and the treatments were inverted. The wounds were evaluated macroscopically and histologically. Results: A larger percentage of scar retraction was observed on the group treated with heterologous PRP, compared to homologous PRP, at the third POD, an increase of 25.03% (p=0.01). No other statistically significant differences among treatments were observed. Among every group, skin healing was efficient, without local adverse effects. Conclusions: Heterologous PRP contributed with more tissue retraction at the beginning of the wound healing process. After this, there were no differences on the wound healing skin process treated with PRP or PPP. However, our findings suggest the presence of others plasmatic factors, besides platelets, which could also contribute to the wound healing process, and thus, should be further investigated.
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Jeong E, Yoo IK, Cakir OO, Kim HK, Kim WH, Hong SP, Cho JY. Effectiveness of Autologous Platelet-Rich Plasma for the Healing of Ulcers after Endoscopic Submucosal Dissection. Clin Endosc 2019; 52:472-478. [PMID: 31096727 PMCID: PMC6785406 DOI: 10.5946/ce.2018.152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 01/17/2019] [Indexed: 12/28/2022] Open
Abstract
Background/Aims Platelet-rich plasma (PRP) has been used for wound healing in various medical fields. The aim of this study was to evaluate the clinical efficacy and safety of local PRP injections after endoscopic submucosal dissection (ESD).
Methods Patients were non-randomly divided into the following two groups: (1) control group in which patients were administered only an intravenous proton pump inhibitor (PPI), and (2) a study group in which patients were administered an intravenous PPI and a topical PRP injection. We assessed the reduction in the ulcer area and stage of the ulcer after the procedure (24 hours, 48 hours, and 28 days after endoscopic surgery).
Results We enrolled 7 study and 7 control patients. In the study group, the rate of ulcer reduction was 59% compared to 52% in the control group (p=0.372), 28 days after ESD. There were 5 patients in the S stage and 2 patients in the H stage in the study group compared to no patient in the S stage and 7 patients in the H stage in the control group (p=0.05), 28 days after ESD. There were no serious complications in either group.
Conclusions The local injection of PRP is a safe and effective procedure for ulcer healing after ESD.
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Affiliation(s)
- Eunju Jeong
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - In Kyung Yoo
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Ozlem Ozer Cakir
- Alanya Alaaddin Keykubat University, School of Medicine Department of Gastroenterology and Hepatology, Antalya, Turkey
| | - Hee Kyung Kim
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Won Hee Kim
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sung Pyo Hong
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Joo Young Cho
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Chicharro-Alcántara D, Rubio-Zaragoza M, Damiá-Giménez E, Carrillo-Poveda JM, Cuervo-Serrato B, Peláez-Gorrea P, Sopena-Juncosa JJ. Platelet Rich Plasma: New Insights for Cutaneous Wound Healing Management. J Funct Biomater 2018; 9:jfb9010010. [PMID: 29346333 PMCID: PMC5872096 DOI: 10.3390/jfb9010010] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 01/14/2018] [Accepted: 01/15/2018] [Indexed: 02/06/2023] Open
Abstract
The overall increase of chronic degenerative diseases associated with ageing makes wound care a tremendous socioeconomic burden. Thus, there is a growing need to develop novel wound healing therapies to improve cutaneous wound healing. The use of regenerative therapies is becoming increasingly popular due to the low-invasive procedures needed to apply them. Platelet-rich plasma (PRP) is gaining interest due to its potential to stimulate and accelerate the wound healing process. The cytokines and growth factors forming PRP play a crucial role in the healing process. This article reviews the emerging field of skin wound regenerative therapies with particular emphasis on PRP and the role of growth factors in the wound healing process.
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Affiliation(s)
- Deborah Chicharro-Alcántara
- Bioregenerative Medicine and Applied Surgery Research Group, Animal Medicine and Surgery Department, Veterinary Faculty, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain.
- García Cugat Foundation for Biomedical Research, 08006 Barcelona, Spain.
| | - Mónica Rubio-Zaragoza
- Bioregenerative Medicine and Applied Surgery Research Group, Animal Medicine and Surgery Department, Veterinary Faculty, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain.
- García Cugat Foundation for Biomedical Research, 08006 Barcelona, Spain.
| | - Elena Damiá-Giménez
- Bioregenerative Medicine and Applied Surgery Research Group, Animal Medicine and Surgery Department, Veterinary Faculty, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain.
- García Cugat Foundation for Biomedical Research, 08006 Barcelona, Spain.
| | - José M Carrillo-Poveda
- Bioregenerative Medicine and Applied Surgery Research Group, Animal Medicine and Surgery Department, Veterinary Faculty, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain.
- García Cugat Foundation for Biomedical Research, 08006 Barcelona, Spain.
| | - Belén Cuervo-Serrato
- Bioregenerative Medicine and Applied Surgery Research Group, Animal Medicine and Surgery Department, Veterinary Faculty, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain.
- García Cugat Foundation for Biomedical Research, 08006 Barcelona, Spain.
| | - Pau Peláez-Gorrea
- Bioregenerative Medicine and Applied Surgery Research Group, Animal Medicine and Surgery Department, Veterinary Faculty, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain.
- García Cugat Foundation for Biomedical Research, 08006 Barcelona, Spain.
| | - Joaquín J Sopena-Juncosa
- Bioregenerative Medicine and Applied Surgery Research Group, Animal Medicine and Surgery Department, Veterinary Faculty, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain.
- García Cugat Foundation for Biomedical Research, 08006 Barcelona, Spain.
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Oliveira MGD, Abbade LPF, Miot HA, Ferreira RR, Deffune E. Pilot study of homologous platelet gel in venous ulcers. An Bras Dermatol 2017; 92:499-504. [PMID: 28954098 PMCID: PMC5595596 DOI: 10.1590/abd1806-4841.20175496] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 06/20/2016] [Indexed: 11/23/2022] Open
Abstract
Background Venous ulcers represent 70% of the lower limb ulcers. They are difficult to
heal, requiring a correct diagnostic and therapeutic approach. Many products
have been developed to healing, such as homologous platelet gel obtained
from the platelet concentrate exceeding from blood transfusion. Objective To evaluate the safety and efficacy of homologous platelet gel in venous
ulcers compared with hydrocolloid dressing. Method A pilot randomized clinical trial in patients with venous ulcers. Randomized
groups (homologous platelet gel and hydrocolloid groups) were followed for
90 days and were assessed through the evolution of ulcerated area,
qualitative analysis of vascularization and adverse events. Both groups used
elastic compression. Results We included 16 participants, with a total of 21 venous ulcers. Both
treatments promoted a reduction of the areas of the ulcers in 90 days (mean
69%), there was significant difference between the groups concerning the
gradual reduction of the ulcers areas, favorably to the hydrocolloid (70% vs
64%; p <0.01). There were some mild adverse events in both groups. Study limitations Single-center study with a small number of patients, preventing more accurate
assessment of the effects of platelet gel. Conclusion The homologous platelet gel associated with the elastic compression can be an
alternative to the venous ulcer treatment and is safe due to the occurrence
of a few mild local adverse events and no serious adverse events. Clinical
trials with larger numbers of patients must be performed to maintain the
indication of this treatment for venous ulcer.
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Affiliation(s)
- Mariele Gobo de Oliveira
- Department of Nursing, Botucatu Medical School - São Paulo State University "Júlio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil
| | - Luciana Patricia Fernandes Abbade
- Department of Dermatology and Radiotherapy, Botucatu Medical School - São Paulo State University "Júlio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil
| | - Hélio Amante Miot
- Department of Dermatology and Radiotherapy, Botucatu Medical School - São Paulo State University "Júlio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil
| | - Rosana Rossi Ferreira
- Department of Biological Sciences, Faculty of Sciences of Bauru - São Paulo State University "Júlio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil
| | - Elenice Deffune
- Cellular Engineering Laboratory, Botucatu Medical School - São Paulo State University "Júlio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil
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Topical application of platelet supernatant gel in the management of radiotherapy-induced mucositis: a case report. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12:107-10. [PMID: 24333059 DOI: 10.2450/2013.0104-13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 05/20/2013] [Indexed: 11/21/2022]
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Use of platelet-rich plasma in the care of sports injuries: our experience with ultrasound-guided injection. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12 Suppl 1:s229-34. [PMID: 23867186 DOI: 10.2450/2013.0293-12] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 03/23/2013] [Indexed: 02/01/2023]
Abstract
BACKGROUND Platelet-rich plasma is being used more frequently to promote healing of muscle injuries. The growth factors contained in platelet-rich plasma accelerate physiological healing processes and the use of these factors is simple and minimally invasive. The aim of this study was to demonstrate the efficacy of ultrasound-guided injection of platelet-rich plasma in muscle strains and the absence of side effects. MATERIALS AND METHODS Fifty-three recreational athletes were enrolled in the study. The patients were recruited from the Emergency Room in the University Hospital at Parma according to a pre-defined protocol. Every patient was assessed by ultrasound imaging to evaluate the extent and degree of muscle injuries. Only grade II lesions were treated with three ultrasound-guided injections of autologous platelet-rich plasma every 7 days. Platelet concentrate was produced according to standard methods, with a 10% variability in platelet count. The platelet gel for clinical use was obtained by adding thrombin to the concentrates under standardised conditions. Outcomes assessed were: pain reduction, muscle function recovery and return to sports activity, ultrasound-imaging tissue healing, relapses, local infections, and any side effect during the treatment. RESULTS In all cases muscle lesions healed fully on ultrasound-imaging, the pain disappeared, and muscle function recovery was documented with a return to sports activity. A single patient had a relapse 1 year after treatment. DISCUSSION Platelet-rich plasma injected into the injury site is one of the most important factors rendering the treatment effective. To maximise its efficacy the preliminary ultrasound must be done accurately to localise the lesion and guide the needle into the corresponding lesion. According to the current results, which document full muscle recovery and no relapse except for one case, platelet-rich plasma ultrasound-guided injection represents a valid mini-invasive treatment for muscle injuries.
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A preliminary study on the potential of manuka honey and platelet-rich plasma in wound healing. Int J Biomater 2012; 2012:313781. [PMID: 23304152 PMCID: PMC3523149 DOI: 10.1155/2012/313781] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 10/30/2012] [Indexed: 01/24/2023] Open
Abstract
Aim. The purpose of this study was to determine the in vitro response of cells critical to the wound healing process in culture media supplemented with a lyophilized preparation rich in growth factors (PRGF) and Manuka honey. Materials and Methods. This study utilized cell culture media supplemented with PRGF, as well as whole Manuka honey and the medical-grade Medihoney (MH), a Manuka honey product. The response of human fibroblasts (hDF), macrophages, and endothelial cells (hPMEC) was evaluated, with respect to cell proliferation, chemotaxis, collagen matrix production, and angiogenic potential, when subjected to culture with media containing PRGF, MH, Manuka honey, and a combination of PRGF and MH. Results. All three cell types demonstrated increases in cellular activity in the presence of PRGF, with further increases in activity seen in the presence of PRGF+MH. hDFs proved to be the most positively responsive cells, as they experienced enhanced proliferation, collagen matrix production, and migration into an in vitro wound healing model with the PRGF+MH-supplemented media. Conclusion. This preliminary in vitro study is the first to evaluate the combination of PRGF and Manuka honey, two products with the potential to increase regeneration individually, as a combined product to enhance dermal regeneration.
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Kim DH, Kim JY, Seo SH, Ahn HH, Kye YC, Choi JE. Recalcitrant cutaneous ulcer of comorbid patient treated with platelet rich plasma: a case report. J Korean Med Sci 2012; 27:1604-6. [PMID: 23255868 PMCID: PMC3524448 DOI: 10.3346/jkms.2012.27.12.1604] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 08/22/2012] [Indexed: 11/20/2022] Open
Abstract
The platelet-rich plasma (PRP) has been advocated as a way to introduce increased concentrations of growth factors and other bioactive molecules to injured tissues in an attempt to optimize the local healing environment. A 94-yr-old woman with various comorbidities presented with a two-week history of severe cutaneous ulcer on the left dorsum of foot. It was caused by recurrent mechanical trauma and did not respond to several wound debridement and simple dressings. However, after she was completed on seven times of autologous PRP treatments, we observed complete healing of the skin lesion within 3 months. Herein, we report a case of recalcitrant cutaneous ulcer with various comorbidities and discuss about the promising possibility of autologous PRP as an effective alternative therapeutic modality.
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Affiliation(s)
- Dai Hyun Kim
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Jong Yeob Kim
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Soo Hong Seo
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Hyo Hyun Ahn
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Young Chul Kye
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Jae Eun Choi
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
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Sell SA, Wolfe PS, Ericksen JJ, Simpson DG, Bowlin GL. Incorporating platelet-rich plasma into electrospun scaffolds for tissue engineering applications. Tissue Eng Part A 2011; 17:2723-37. [PMID: 21679135 PMCID: PMC3204198 DOI: 10.1089/ten.tea.2010.0663] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 06/15/2011] [Indexed: 12/21/2022] Open
Abstract
Platelet-rich plasma (PRP) therapy has seen a recent spike in clinical interest due to the potential that the highly concentrated platelet solutions hold for stimulating tissue repair and regeneration. The aim of this study was to incorporate PRP into a number of electrospun materials to determine how growth factors are eluted from the structures, and what effect the presence of these factors has on enhancing electrospun scaffold bioactivity. PRP underwent a freeze-thaw-freeze process to lyse platelets, followed by lyophilization to create a powdered preparation rich in growth factors (PRGF), which was subsequently added to the electrospinning process. Release of protein from scaffolds over time was quantified, along with the quantification of human macrophage and adipose-derived stem cell (ADSC) chemotaxis and proliferation. Protein assays demonstrated a sustained release of protein from PRGF-containing scaffolds at up to 35 days in culture. Scaffold bioactivity was enhanced as ADSCs demonstrated increased proliferation in the presence of PRGF, whereas macrophages demonstrated increased chemotaxis to PRGF. In conclusion, the work performed in this study demonstrated that the incorporation of PRGF into electrospun structures has a significant positive influence on the bioactivity of the scaffolds, and may prove beneficial in a number of tissue engineering applications.
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Affiliation(s)
- Scott A Sell
- Physical Medicine and Rehabilitation, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia 23249, USA.
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Carter MJ, Fylling CP, Parnell LKS. Use of platelet rich plasma gel on wound healing: a systematic review and meta-analysis. EPLASTY 2011; 11:e38. [PMID: 22028946 PMCID: PMC3174862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Autologous platelet rich plasma is an advanced wound therapy used in hard-to-heal acute and chronic wounds. To better understand the use and clinical outcomes of the therapy, a systematic review of the published literature in cutaneous wounds was performed. METHODS Electronic and hand searches for randomized controlled trials and comparative group studies using platelet rich plasma therapy in cutaneous wounds and published over the last 10 years was conducted. Eligible studies compared the treatment to standard care or other interventions. All citations were screened and eligible studies were assessed for validity, quality, and bias using accepted scoring methods. The primary outcomes were effect of platelet rich plasma and control wound care on wound healing and related healing measurements. Secondary outcomes related to healing such as infection, pain, exudate, adverse events, and quality of life were also considered. The meta-analysis utilized appropriate statistical methods to determine the overall treatment effect on chronic and acute wound healing and infection. RESULTS The search terms resulted in 8577 citations and after removing duplicates and screening for protocol eligibility, a total of 24 papers were used. The meta-analysis of chronic wound studies revealed platelet rich plasma therapy is significantly favored for complete healing. The meta-analysis of acute wounds with primary closure studies demonstrated that presence of infection was reduced in platelet rich plasma treated wounds. CONCLUSIONS This systematic review and meta-analysis of platelet rich plasma therapy in cutaneous wounds showed complete and partial wound healing was improved compared to control wound care.
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