The Use of Autologous Platelet Gel in Toenail Surgery: A Within-Patient Clinical Trial

Intramatricial platelet‐rich plasma in nail disorders: Amending the methodological omissions and unethical commissions

“…The results from both studies were very similar with better intraoperative homeostasis being the only noteworthy benefit of activated PRP gel or APG, with negligible impact on reduction of postoperative pain or recovery time. 6,8 These two studies conducted within the past decade clearly contradict the authors' aforementioned assertion. However, the discouraging results of activated PRP gel in surgical treatment of onychocryptosis should not be generalized or blindly extrapolated to other nail disorders.…”

“…• The authors should have classified and quantified the PRP used in both cases, ideally as per Dohan Ehrenfest et al's classification. 5 Although the relative proportion of pro-inflammatory and anti-inflammatory growth factors in unclassified PRP, and its correlation with platelet count and clinical effects warrant exploration, 6 the authors should have considered the well-established differences between the leukocyte-poor pure PRP (P-PRP) with predominantly anti-inflammatory and leukocyte-rich PRP (L-PRP) with predominantly pro-inflammatory properties. The latter reportedly impedes healing of injured soft tissues.…”

Effectiveness of Leukocyte and Platelet-Rich Fibrin versus Nitrofurazone on Nail Post-Surgery Bleeding and Wound Cicatrization Period Reductions: A Randomized Single Blinded Clinical Trial

“…The effectiveness of L-PRF was compared with nitrofurazone for the treatment of chemical matrixectomies with 88% phenol solution. Previous investigations by Córdoba-Fernández et al reported that application of platelet-rich plasma in onychocryptosis contributed to the improvement in acute inflammation, but a reduction in postoperative pain was not achieved [16,17].…”

“…Finally, both treatments were repeated at 48 h and for the next five consecutive days. Afterwards, the treatment consisted of application of povidone iodine until cicatrization of the nail was complete [16].…”

“…The primary outcome measurement was post-surgical bleeding, which was categorized as mild (the dressing did not show external spots; only the polypropylene of the dressing was in contact with the wound, and the gauze was in contact with the dressing), moderate (the dressing might have shown slight spots on the back or sides; the non-adherent dressing might have been completely stained and the gauze in contact with it may have been partially stained), or heavy bleeding (the external bandage could be completely or almost completely colored) [17]. The secondary outcome measurements were post-surgical pain intensity as assessed by the visual analogue scale (VAS, showing an intraclass correlation coefficient of 0.97) on the first, second, and third days after surgery [18], post-surgical inflammation as measured by the digital circumference in mm using a flexible ruler (Devon Industries 1-800, Inc., Devon, PA, USA) at the level of the proximal nail fold before and 48 h after surgery during the acute inflammatory phase of healing [16], presence of infection, analgesic intake for post-surgical pain (measured as mg of paracetamol, Termalgin (Novartis Farmacéutica SA, Barcelona, Spain)), and post-surgical wound cicatrization measured as days of cicatrization of the post-surgical wound (days from the surgery to clinical recovery) [16,17].…”