Autologous platelet-rich fibrin (PRF) augmentation as an add-on therapy in deep surgical site infections (dSSIs) after instrumented spinal surgery: preliminary results of a single institution case series

Vasilikos, Ioannis; Roelz, Roland; Scholz, Christoph; Mizaikoff, Boris; Argiti, Katerina; Watzlawick, Ralf; Giagkos, Georgios-Christos; Fragkakis, Evangelos M.; Ghanaati, Shahram; Beck, Jürgen; Hubbe, Ulrich

doi:10.1007/s00701-021-04952-7

Cited by 3 publications

(3 citation statements)

References 33 publications

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“…Vasilikos added PRF to 12 patients at the time of the second surgical revision. All patients achieved complete wound healing between 14 and 21 days, and no recurrence of dSSI or complications were observed during follow-up ( 127 ).…”

Section: Application Of Prp In Spine Surgerymentioning

confidence: 94%

Application of platelet-rich plasma in spinal surgery

et al. 2023

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With the aging of the population and changes in lifestyle, the incidence of spine-related diseases is increasing, which has become a major global public health problem; this results in a huge economic burden on the family and society. Spinal diseases and complications can lead to loss of motor, sensory, and autonomic functions. Therefore, it is necessary to identify effective treatment strategies. Currently, the treatment of spine-related diseases includes conservative, surgical, and minimally invasive interventional therapies. However, these treatment methods have several drawbacks such as drug tolerance and dependence, adjacent spondylosis, secondary surgery, infection, nerve injury, dural rupture, nonunion, and pseudoarthrosis. Further, it is more challenging to promote the regeneration of the interstitial disc and restore its biomechanical properties. Therefore, clinicians urgently need to identify methods that can limit disease progression or cure diseases at the etiological level. Platelet-rich plasma (PRP), a platelet-rich form of plasma extracted from venous blood, is a blood-derived product. Alpha granules contain a large number of cytokines, such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), epidermal growth factor, platelet factor 4 (PF-4), insulin-like growth factor-1 (IGF-1), and transforming growth factor-β (TGF-β). These growth factors allow stem cell proliferation and angiogenesis, promote bone regeneration, improve the local microenvironment, and enhance tissue regeneration capacity and functional recovery. This review describes the application of PRP in the treatment of spine-related diseases and discusses the clinical application of PRP in spinal surgery.

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Section: Application Of Prp In Spine Surgerymentioning

confidence: 94%

Application of platelet-rich plasma in spinal surgery

et al. 2023

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“…Platelet‐rich fibrin (PRF), an autologous concentration of platelets and growth factors, has emerged as a promising therapeutic agent in the realm of wound healing. Its potential to accelerate tissue regeneration and wound healing has been explored in various surgical contexts 2,3 . Furthermore, the combination of PRF with other therapeutic agents, such as Pentoxifylline/Tocopherol, has shown promise in preventing complications like osteoradionecrosis 4 …”

Section: Introductionmentioning

confidence: 99%

“…Its potential to accelerate tissue regeneration and wound healing has been explored in various surgical contexts. 2,3 Furthermore, the combination of PRF with other therapeutic agents, such as Pentoxifylline/Tocopherol, has shown promise in preventing complications like osteoradionecrosis. 4 In the realm of oral surgery, there's an increasing focus on the wound-healing processes of both soft and hard tissues.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic efficacy of platelet‐rich fibrin on surgical site wound healing in patients undergoing oral carcinoma resection: A meta‐analysis

Long,

Li,

et al. 2023

International Wound Journal

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Oral carcinoma, a prevalent malignancy of the oral cavity, often results in surgical site wounds post‐resection. The therapeutic efficacy of platelet‐rich fibrin (PRF) in wound healing and scar formation has garnered significant attention. This meta‐analysis aimed to evaluate the role of PRF in promoting surgical site wound healing and reducing scar formation following oral carcinoma resection. A systematic search, adhering to PRISMA guidelines, was conducted across multiple databases. The primary outcomes assessed were the Landry, Turnbull and Howley (LTH) wound healing index and the Manchester scar scale (MSS). Statistical evaluations were performed using RevMan 5.4 software. Six studies were incorporated, involving 93 patients treated with PRF and 97 in the control group. For the LTH index, significant improvements in wound healing were observed in the PRF group with I2 = 74%, (Random: SMD: 3.70, 95% CIs: 2.66 to 4.75, p < 0.01). The Manchester scar scale assessment, which included 60 PRF‐treated patients and 60 controls, indicated a significant reduction in scar formation in the PRF group I2 = 79%, (Random: SMD: 9.13, 95% CIs: 6.06 to 12.20, p < 0.01). PRF demonstrates promising therapeutic potential in enhancing surgical site wound healing and reducing scar formation post oral carcinoma resection. The application of PRF has been associated with improved wound healing metrics and diminished scar severity. However, further high‐quality studies are warranted to confirm these findings.

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Platelet rich fibrin three-layer reconstruction of the sellar floor after endoscopic endonasal transsphenoidal approach: technical note and initial experience

Shah,

Argiti,

Nakagawa

et al. 2024

Front. Surg.

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BackgroundCerebrospinal fluid (CSF) leakage frequently complicates endoscopic endonasal transsphenoidal pituitary resections, despite the use of lumbar drains, nasoseptal flaps, or commercial dura sealants. Managing this complication often requires revision surgery and increases the risk of infection. Platelet-rich fibrin (PRF), an affordable autologous biomaterial derived from the patient's blood through short, angulated centrifugation, contains growth factors and leukocytes embedded in a fibrin matrix. PRF exhibits regenerative properties in various surgical disciplines. This study assesses a three-layer sellar reconstruction method employing solid membranous (s-PRF) and high-viscosity injectable (i-PRF) forms of PRF.Materials and methodsWe present our initial experience on a series of 22 patients with pituitary macroadenomas. For all patients, an endoscopic transnasal transsphenoidal approach was selected. Following the resection of the pathology, sellar reconstruction was accomplished using a three-layer orthobiologic technique. A membranous s-PRF was utilized as an inlay inside the opened sellar floor, followed by a layer of injectable i-PRF finally covered with another s-PRF membrane over the top to the sellar corridor.ResultsIn all cases the implementation of the proposed three-layer PRF reconstruction strategy was feasible and safe. During the 12-month follow-up period there were no adverse effects reported associated with the PRF application. 77% (17/22) of the patients demonstrated intraoperatively a cerebrospinal fluid (CSF) leak (Esposito Grade 1–3). In total, the proposed PRF reconstruction effectively prevented postoperative CSF leaks in 95% of the patients and in 94% of those with an Esposito Grade 1–3. One of the two patients with intraoperative Esposito Grade 3 developed a CSF leak on the first postoperative day, which was successfully managed with a lumbar drain for 5 days.ConclusionSellar reconstruction after endoscopic endonasal transsphenoidal resection of pituitary adenomas with PRF is feasible and safe. The three layer PRF augmentation is a novel technique to prevent CSF-leakage.

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Autologous platelet-rich fibrin (PRF) augmentation as an add-on therapy in deep surgical site infections (dSSIs) after instrumented spinal surgery: preliminary results of a single institution case series

Cited by 3 publications

References 33 publications

Application of platelet-rich plasma in spinal surgery

Application of platelet-rich plasma in spinal surgery

Therapeutic efficacy of platelet‐rich fibrin on surgical site wound healing in patients undergoing oral carcinoma resection: A meta‐analysis

Platelet rich fibrin three-layer reconstruction of the sellar floor after endoscopic endonasal transsphenoidal approach: technical note and initial experience

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