Evaluation of 24 protocols for the production of platelet-rich fibrin

Abstract

Background The aim of this study was to evaluate 24 protocols for the production of platelet rich fibrin (PRF) produced via horizontal centrifugation to better understand cell separation following protocols at various times and speeds.Methods All protocols were compared utilizing a recent method to quantify cells in PRF in 1 mL sequential layers pipetted from the upper layer downwards until all 10 mL were harvested. In total, 960 complete blood counts (CBCs) were investigated. Both solid and liquid-based PRF protocols were investigated following 24 protocols involving 6 relative centrifugal force (RCF) values (100,200,400,700,1000 and 1200g) at 4 centrifugation times (3,5,8 and 12 minutes).Results In general, platelets could more easily accumulate in the upper 4 layers when compared to leukocytes owing to their lower cellular density. Protocol time seemed to have a greater impact on the final cell layer separation when compared to the effect of speed. Protocols of greater than 8 minutes at 400 g led to no leukocyte accumulation in the upper PRF layers (found specifically within the buffy coat). Protocols at or below 200 g were unable to effectively accumulate platelets/leukocytes. The optimal centrifugation speed and time for solid-PRF ranged between 400 -700 g for 8 minutes. It was noted that variability in patient baseline platelet/leukocyte/erythrocyte counts (hematocrit) significantly affected cell layer separation. This finding was more pronounced at lower centrifugation speeds.Conclusions Within the investigated ranges, a protocol of 700 g for 8 minutes presented the highest yield of platelets/leukocytes evenly distributed throughout the upper PRF layers.

The Second-Generation Platelet Concentrates in the Treatment of Chronic Osteomyelitis: One Modern Regenerative Surgery

“…The fibrin clot is extracted from the test tube with sterile forceps and the PRF is obtained by removing the red clot from its lower end. The success of this technique depends entirely on the ease of blood collection and the speed of transfer in the centrifuge [10]. The entire process must always be carried out in a sterile manner, because the growth factors contained stimulate tissue regeneration and, therefore, probably, also that of bacteria.…”

Clinical Trial on Solid 2nd Generation Platelet-Concentrates in the Management of the Chronic Osteomyelitis: A Advanced Regenerative Surgeries

“…Blood samples of each patient were also taken to perform a complete blood count (CBC) using K3E tubes with 5.4 mg EDTA (VacuMed). As reported by previous investigation [6][7][8][9][10][11], three blood samples were taken from the left brachial vein of each person through an 18-gauge needle, two for PRF generation and one for cellular blood count. The samples were processed with a Cell Dyn 3500 R cell counter (ABBOTT).…”

Clinical Trial on Solid 2nd Generation Platelet-Concentrates in the Management of the Chronic Osteomyelitis: An Advanced Regenerative Surgeries

“…Using the L-PRF Wound Box, the membrane stress procedure in coagulation is performed through light, homogeneous stress, and the resulting membrane remains consistently moist and evenly wet in serum. The PRF fabrication method is extremely simple and requires only a blood test and a DUO Quattro per PRF tabletop centrifuge specifically designed for this method (DUO Quattro per PRF) [6][7][8][9].…”

“…Each membrane is separated into three equivalent size areas: proximal (head), central (body) and distal (tail) through a sterile scalpel cut. Only the proximal portion of the membrane has been used [9,10] and the central portion only if important.…”

“…1), FGF-2, HGF, and growth factor similar to insulin-1 (IGF-1). Analyzing three pro-inflammatory cytokines (IL-1β, IL-6, TNF-α), one inflammatory cytokine (IL-4) and one angiogenesis activator (VEGF), it was suggested that PRF might also be a focus of immune modeling with the potential to control inflammation and multiplication of non-differentiated adult cells, comprising CD34+ precursor cells, MSCs (mesenchymal stem cells), SMC progenitors (smooth muscle cells) and endothelial precursors [8][9][10][11]. The multiple power of these types of stem cells and their increased capacity to increase vascular tissue repair and through paracrine mechanisms also make them as therapeutic vehicles in restorative medicine.…”