This document discusses platelet concentrates and their role in wound healing. It describes techniques for obtaining platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) through blood centrifugation. PRP and PRF contain growth factors that are released from platelet granules and promote wound healing through angiogenesis, collagen synthesis, and recruitment of cells. The document outlines the clinical applications of PRP and PRF in various surgical procedures and injuries to enhance healing. It also reviews the advantages and limitations of different platelet concentrate collection methods.

1. Platelet concentrate techniques

2. • In 1970 various methods fibrin adhesives was
described
• In 1974 regenerative properties of platelets
were described by Ross et al
• Various practices of using platelet
concentrates and fibrin adhesives were in
practice from 1970s
• In 2001 , Chorkoun et al described techique of
PRF

3. Role of platelets in wound healing
• release of subendothelial factors that attract
circulating platelets and activate coagulation
proteins
• Platelets aggregate and adhere and release
granules containing serotonin, thromboxane, and
adenosine, and initiate coagulation and the
formation of fibrin
• Activation platelets by thrombin causes
hemostatic plug formation
• thrombin-dependent cell activation and platelet
dependent angiogenesis

4. • Platelet derived growth factor
– Enhances proteoglycan and collagen synthesis
– Recruits macrophages and fibroblasts
• Endothelial growth factor
– Angiogenesis by endothelial migration
– Stimulates collagenase secretion by fibroblasts to remodel
matrix
• TGF B
– Promotes angiogenesis
– Establishes chemoattractant gradients,
– induces adhesion molecule expression,
– promotes proinflammatory
– stimulate leukocyte and fibroblast migration
– Induces extracellular matrix synthesis by inhibiting
protease activity and upregulating collagen and
proteoglycan synthesis

5. Fibrin
• Final product of coagulation cascade
• Forms the three dimentional mesh for platelet
aggregation and futher collagen deposition
and fibroblast migration
• Rich in plasma and alpha granules

6. Platelet rich plasma

7. • Step 1- venous blood colleceted with
anticoagulant
• Step2- soft spin
• Step3- PPP and PRP aspirated and collected in
other tube without anti coagulant
• Step 4 – Hard spin
• Step 5 – discard PPP, rest is gently shaken
• Step 6- add bovine thrombin and calcium chloride

8. • cPRP is obtained either in gel or spray form
• Can be made into cPRP membrane by adding
fibrin adhesives

9. Presence of WBCs in PRP
• Advantage
– Better inflamatory reaction – infection control and
better results in wounds with some devitalised
tissues
• Disadvantage
– Delay regenerative process
– Cytotoxic destruction
– Suppress bone healing

10. Buffy coat system Vs Plasma based
systems
Buffy coat systems
Plasma based systems

11. Properties
• Denser polymerisation
• Cytokines effect is time limited
• Good adhesive and hemostatic property
• Cytokine release too quick to be incorperated
in fibrin clot.
• Clinical results tends to be similar to fibrin
adhesives

12. • Full and split-thickness skin grafts donor sites
andrecipient sites
• Skin flaps
• Bone grafts
• Metal implants
• Tissue expansion
• Reconstructions

13. • Recurrent Hernia Repair
• Anal Fistula
• Sternotomy
• Total Hip Replacement
• Total Knee Replacement
• Scoliosis Repair
• Spinal Fusion
• All Open and Internal Reduction Fixation
• Radical neck dissection

14. Plasma rich fibrin
• First developed in France by Choukroun et al
in 2001 for maxilo facial surgeries
• To avoid all the restrictions of the French law
related to blood-derived product
reimplantation

15. Technique
• Venous blood collected in 10ml tubes without
any anticoagulant
• Centrifuge for 15minutes at 3000RPM

17. PRF advantages
• No biochemical handling of blood
• Simplified and cost effective
• Use of bovine thrombin and antocoagulants
not required
• Slow polymerisation
• More efficient cell migration and proliferation
• Favourable interacion with immune system

18. Clinical uses
• First described to be used along with FDBG in dento
maxilary surgeries for sinus lift, to prevent bone
resorption in extraction sockets
• Biological connector betweeen bone graft and recepint
bed.
• Improves angiogenesis , there by granulation tissue
• In alopecia, it is used as intradermal injection along
with hair follicle transplant
• In musculo skeletal injuries, especially tendon injuries,
ultrasound guided injections are found to be useful

19. Contraindications
• coagulopathies and disorders of platelet
function
• anemic and those with thrombocytopenia
• hemodynamic instability,severe hypovolemia,
• unstable angina,
• sepsis
• anticoagulant or fibrinolytic drug therapy

20. Referance
• Platelet-rich Plasma:Properties and Clinical
Applications, RICK G. SMITH,
• Platelet-rich fibrin (PRF): A second-generation
platelet concentrate,David M.
• A Prospective, Randomized, ControlledTrial of
Autologous Platelet-RichPlasma Gel for the
Treatment ofDiabetic Foot Ulcers,Vickie R.
Driver