Modulation of Wound Response and Soft Tissue Ingrowth in Synthetic and Allogeneic Implants With Platelet Concentrate

Abstract

To evaluate the modulation of wound healing and soft tissue ingrowth in synthetic and allogeneic implants with platelet gel. Attempts to influence wound healing with exogenous growth factors are highly dependent on the timing and dosing of treatment. Platelet gel made fromautologousplateletconcentrate(PC)andactivatedwith calcium thrombin is increasingly used to enhance healing of surgical and chronic wounds, based on the assumption that proteins found in the blood can promote healing.Methods: Adult New Zealand white rabbits underwent phlebotomy, and the blood was used to produce nonconcentrated autologous blood clot, platelet-poor plasma (PPP), and PC for each animal. Disks of porous high-density polyethylene (PHDPE) and acellular dermal graft (ADG) were implanted into each animal in a subcutaneous location. Implants of each type were treated with isotonic sodium chloride solution, PPP, PPP followed immediately with PC, or autologous blood clot (by means of manual impregnation). Animals were killed at 2, 7, 14, and 21 days after implantation. Implants were harvested with surrounding soft tissue and examined by means of light microscopy for evidence of acute and chronic inflammatory cells and vascular and fibroblast invasion.Results: A platelet gel with platelet concentrations averaging 5.8 times greater than those of peripheral blood significantly improved wound healing and soft tissue ingrowth

The use of autologous platelet–leukocyte gels to enhance the healing process in surgery, a review

“…Autologous platelet growth factors have been used by Zieren et al [39], who showed enhanced ingrowth and increased cell proliferation with a higher number of fibroblasts/collagen fibers in abdominal hernia repair, suggesting a role of platelet growth factors in the healing process. Sclafani et al [40] showed an accelerated maturation of wounds in an experimental setting when PLG was used. On the basis of these findings, we have initiated a research program to confirm whether the application of PLG is useful for hernia repair in a clinical setting.…”

What We Have Learned About Soft-Tissue Augmentation Over the Past 10 Years

“…However, we also noted rapid loss of clinical volume when ADG was injected subdermally, 3 and a similar lymphocytic response was noted when sheet ADG was implanted into rabbits. 7 Since minimal lymphocytic response was noted in the human biopsy specimens taken over the first year after implantation, this likely represents an immune response to a xenograft. So what have we learned in the past decade?…”

Safety, Efficacy, and Utility of Platelet-Rich Fibrin Matrix in Facial Plastic Surgery

“…In a study examining the effects of PRP, my colleagues and I noted an early increase in endothelial cells and fibroblasts in a wound, which did not persist after 7 days. 6 This early effect on fibroblasts and endothelial cells, however, spurred our interest in harnessing the body's natural mechanisms for wound repair and collagen production for use in softtissue augmentation.…”