Comparison of the Regenerative Effects of Platelet-Rich Fibrin and Plasma Rich in Growth Factors on Injured Peripheral Nerve: An Experimental Study

Torul, Damla; Bereket, Mehmet Cihan; Önger, Mehmet Emin; Altun, Gamze

doi:10.1016/j.joms.2018.04.012

Cited by 19 publications

(18 citation statements)

References 45 publications

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“…The fibrin matrix scaffold network in PRF appears to be beneficial in tissue regeneration [6]. PRF has shown to enhance regeneration of bone [1,7], cartilage [8], soft tissue [5,9,10,11], and nerve fiber [12]. However, the application of solid PRF, resulting from a blood sample preparation at 400 g relative centrifugal force (RCF) or 2700 round per minute (rpm) for 12 min, has its limitations.…”

Section: Introductionmentioning

confidence: 99%

Influence of Fractionation Methods on Physical and Biological Properties of Injectable Platelet-Rich Fibrin: An Exploratory Study

Thanasrisuebwong

Surarit

Bencharit

et al. 2019

IJMS

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Injectable platelet-rich fibrin (i-PRF) has been used as an autografting material to enhance bone regeneration through intrinsic growth factors. However, fractionation protocols used to prepare i-PRF can be varied and the effects of different fractionation protocols are not known. In this study, we investigated the influence of different fractions of i-PRF on the physical and biological properties derived from variations in i-PRF fractionation preparation. The i-PRF samples, obtained from the blood samples of 10 donors, were used to harvest i-PRF and were fractioned into two types. The yellow i-PRF fractionation was harvested from the upper yellow zone, while the red i-PRF fractionation was collected from both the yellow and red zone of the buffy coat. The viscoelastic property measurements, including the clot formation time, α-angle, and maximum clot firmness, were performed by rotational thromboelastometry. The fibrin network was examined using a scanning electron microscope. Furthermore, the concentration of growth factors released, including VEGF, TGF-β1, and PDGF, were quantified using ELISA. A paired t-test with a 95% confidence interval was used. All three viscoelastic properties were statistically significantly higher in the yellow i-PRF compared to the red i-PRF. The scanning electron microscope reviewed more cellular components in the red i-PRF compared to the yellow i-PRF. In addition, the fibrin network of the yellow i-PRF showed a higher density than that in the red i-PRF. There was no statistically significant difference between the concentration of VEGF and TGF-β1. However, at Day 7 and Day 14 PDGF concentrations were statistically significantly higher in the red i-PRF compared to the yellow group. In conclusion, these results showed that the red i-PRF provided better biological properties through the release of growth factors. On the other hand, the yellow i-PRF had greater viscoelastic physical properties. Further investigations into the appropriate i-PRF fractionation for certain surgical procedures are therefore necessary to clarify the suitability for each fraction for different types of regenerative therapy.

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Section: Introductionmentioning

confidence: 99%

Influence of Fractionation Methods on Physical and Biological Properties of Injectable Platelet-Rich Fibrin: An Exploratory Study

Thanasrisuebwong

Surarit

Bencharit

et al. 2019

IJMS

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“…Many different wraps have been considered in clinical practice; in addition to synthetic products, also collagen-based, fat, muscle, fascia have been used too 9,10 . In recent years, hemocomponents like platelet-rich-plasma (PRP) and platelet-rich-fibrin (PRF) have gained wide attention; however their effects on peripheral nerve regeneration are still controversial as reported in both preclinical and clinical studies 15–18 . Beside to applications of the PRP in the form of injectable gel 19,20 , in the literature its use as a fibrin membrane is also reported 21 .…”

Section: Introductionmentioning

confidence: 99%

New bioresorbable wraps based on oxidized polyvinyl alcohol and leukocyte-fibrin-platelet membrane to support peripheral nerve neurorrhaphy: preclinical comparison versus NeuraWrap

Stocco

Barbon

Macchi

et al. 2019

Sci Rep

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Nerve wrapping improves neurorrhaphy outcomes in case of peripheral nerve injuries (PNIs). The aim of this preclinical study was to assess the efficacy of two novel biodegradable wraps made of a synthetic 1% oxidized polyvinyl alcohol (OxPVA) and a natural leukocyte-fibrin-platelet membrane (LFPm) versus the commercial product NeuraWrap. After rats sciatic nerve transection and neurorrhaphy, the wraps were implanted and compared for functional outcome, by sciatic function index assessment; structural characteristics, by histological/immunohistochemical analysis; ultrastructural features, by transmission electron microscopy. Moreover, a morphometric study was also performed and collagen distribution was observed by Second Harmonic Generation microscopy. After 12 weeks from implantation, all wraps assured nerve function recovery; no scar tissue/neuromas were visible at dissection. LFPm wraps were completely resorbed, while residues of OxPVA and NeuraWrap were observed. In all groups, biocompatibility was confirmed by the absence of significant inflammatory infiltrate. According to histological/immunohistochemical analysis and morphometric findings, OxPVA and LFPm wraps were both effective in preserving nerve integrity. These results assess that bioengineered OxPVA and LFPm wraps successfully guarantee favorable lesion recovery after PNI/neurorrhaphy and, in future, may be considered an interesting alternative to the commercial NeuraWrap.

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“…Previous studies have mostly used single intraoperative PRP treatment that was injected perineurally as a liquid-to-gel injectable scaffold or wrapped around the injured nerve gap as a matrix-like viscous and malleable structure, and conflicting curative results have been reported 16,26 . The inconsistency among results may be due to the differential frequency of PRP treatment and PRP concentrations 6,15,16,26 . Few studies have investigated the therapeutic effect of PRP membrane-wrapped damaged nerves intraoperatively combined with serial ultrasound-guided PRP scaffold injection postoperatively on peripheral nerve crush injury (Fig.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided platelet-rich plasma injection and multimodality ultrasound examination of peripheral nerve crush injury

et al. 2020

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Ultrasound-guided platelet-rich plasma (PRP) injection is able to make up for the limitations of applying a single growth factor. The goal of this study was to investigate the effects of serial ultrasound-guided PRP injections of the appropriate concentration on the treatment of sciatic nerve crush injury, and explore the value of multimodality ultrasound techniques in evaluating the prognosis of crushed peripheral nerve. In vitro, optimal concentration of PRP (from 150%, 250%, 450%, and 650%) was screened due for its maximal effect on proliferation and neurotrophic function of Schwann cells (SCs). In vivo, ninety rabbits were equally and randomly divided into normal control, model, PRP-2.5×, PRP-4.5×, and PRP-6.5× groups. The neurological function and electrophysiological recovery evaluation, and the comparison of the multimodality ultrasound evaluation with the histological results of sciatic nerve crush injury were performed to investigate the regenerative effects of PRP at different concentrations on the sciatic nerve crush injury. Our results showed that the PRP with a 4.5-fold concentration of whole blood platelets could significantly stimulate the proliferation and secretion of SCs and nerve repair. The changes in stiffness and blood perfusion were positively correlated with the collagen area percentage and VEGF expression in the injured nerve, respectively. Thus, serial ultrasound-guided PRP injections at an appropriate concentration accelerates the recovery of axonal function. Multimodality ultrasound techniques provide a clinical reference for prognosis by allowing the stiffness and microcirculation perfusion of crush-injured peripheral nerves to be quantitatively evaluated.

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Comparison of the Regenerative Effects of Platelet-Rich Fibrin and Plasma Rich in Growth Factors on Injured Peripheral Nerve: An Experimental Study

Cited by 19 publications

References 45 publications

Influence of Fractionation Methods on Physical and Biological Properties of Injectable Platelet-Rich Fibrin: An Exploratory Study

Influence of Fractionation Methods on Physical and Biological Properties of Injectable Platelet-Rich Fibrin: An Exploratory Study

New bioresorbable wraps based on oxidized polyvinyl alcohol and leukocyte-fibrin-platelet membrane to support peripheral nerve neurorrhaphy: preclinical comparison versus NeuraWrap

Ultrasound-guided platelet-rich plasma injection and multimodality ultrasound examination of peripheral nerve crush injury

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