Platelet-Rich Fibrin Enhances Surgical Wound Healing in Total Laryngectomy

Abstract

Autologous growth factor (AGF) is a cytokine that has gained medical research interest because it helps improve and accelerate the wound healing process. Platelet-rich fibrin (PRF) is the latest generation of platelet concentrate that can be obtained through a simple procedure known as AGF referencing. One of the most common complications of total laryngectomy (TL) is pharyngocutaneous fistula. To prevent this complication, health care providers must closely monitor the postoperative wound healing process.This study aimed to investigate the effectiveness of PRF application in enhancing wound healing after TL. A randomized controlled trial was conducted in the Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital Universitas Indonesia, Jakarta, Indonesia, from June 2019 to December 2019. We included 20 patients who underwent TL for laryngeal squamous cell carcinoma. They were divided into two groups (10 patients who received applied autologous PRF around the esophageal stoma during TL and another 10 patients as the control). These patients were observed for 2 weeks postoperatively. In the bivariate analysis performed using the chi-square test, the pain threshold and edema of postoperative wounds in the PRF-treated group demonstrated significant differences compared with those in the control group. PRF application in TL enhanced the postoperative wound healing process, especially with regard to edema and pain.

Impact of autologous platelet concentrates on wound area reduction: A meta‐analysis of randomized controlled trials

“…28,36 Platelet concentrates offer not only wound healing and tissue regeneration benefits but also aid in pain reduction and infection prevention during treatment. 13,37 However, the precise mechanism of action of growth factors within APCs in different wound types and stages of wound healing remains unclear. Furthermore, the influence of platelet activation and potential adverse reactions associated with the preparation of certain APCs products require further elucidation, along with the establishment of standardized preparation protocols.…”

“…Platelet concentrates offer not only wound healing and tissue regeneration benefits but also aid in pain reduction and infection prevention during treatment 13,37 . However, the precise mechanism of action of growth factors within APCs in different wound types and stages of wound healing remains unclear.…”

Current and Future Developments in Wound Healing

“…63 The benefit of using autologous PRP to improve wound healing in acute wounds is more controversial but favors reduced risk of infections. 64 Additionally, promising future applications in otolaryngology for autologous PRP include enhanced wound healing following total laryngectomy, 65 improved vocal quality in treatment of vocal fold scar and atrophy, 66,67 and improved healing of chronic tympanic membrane perforations following tympanoplasty. 68,69 Hair Follicle Transplantation Brown and McDowell were the first to observe that wounds in areas without hair follicles, such as the palms and soles, heal slower than wounds in hair-bearing areas and proposed that hair follicles play a role in wound healing.…”

Effect of amniotic membrane/collagen scaffolds on laryngeal cartilage repair

“…Various treatment modalities, materials, and drugs have been introduced to facilitate laryngeal cartilaginous healing and prevent complications. Several clinical and experimental studies have shown different degrees of success and limitations of these treatment modalities, such as the use of amniotic membrane (AM), 2 adipose‐derived stem cells (ASCs), 3 seeded scaffolds, 4 and platelet‐rich plasma (PRP) 5 in laryngeal defects repair.…”

“…as the use of amniotic membrane (AM), 2 adipose-derived stem cells (ASCs), 3 seeded scaffolds, 4 and platelet-rich plasma (PRP) 5 in laryngeal defects repair.…”