Easy Platelet-Rich Fibrin (Injectable/Topical) for Post-resurfacing and Microneedle Therapy

The Role of Leukocyte-Platelet-Rich Fibrin in Promoting Wound Healing in Diabetic Foot Ulcers

To explore the effect of leukocyte-platelet-rich fibrin (L-PRF) on promoting wound healing in diabetic foot ulcers. A total of 42 patients with diabetic foot ulcers at our hospital from January 2017 to July 2020 were retrospectively analyzed. A control group and a PRF group were established. The two groups of patients underwent debridement. In the platelet-rich fibrin (PRF) group, autologous L-PRF was used to cover ulcer wounds. One time each week, Vaseline gauze was used to cover the ulcer wounds. In contrast, the control group was treated with the external application of mupirocin ointment and recombinant human epidermal growth factor gel (yeast). Two times each week, the sterile Vaseline gauze was covered with a bandage. Both groups were treated for 5 weeks. The wound recovery of the two groups was observed. During the early stage of treatment (first and second weeks) for diabetic foot ulcers, the wound healing rate was significantly better with L-PRF treatment than traditional treatment. For later-stage treatment (third to fifth weeks), the overall cure rate was higher with L-PRF than the traditional treatment method. L-PRF can effectively promote wound healing in diabetic foot ulcers.

Versatility of Transport Distraction Osteogenesis for Reconstruction of Lateral Mandibular Ablative Defects

Introduction

The reconstitution of form and function after maxillofacial tumor resection or traumatic bony defects is a challenge when considering reconstructive options. The reconstructive options will depend upon whether the tissues to be replaced included bone alone or both bone and soft tissue (composite resection).

Methodology

This study was carried out on nine patients who with benign tumors or cysts of the mandible that required segmental resection. Mandibular reconstruction using mandibular transport distraction osteogenesis was performed for all the cases. Depending on whether the condyle was spared or sacrificed, the type of mandibular transport distractor either fixed on the remnant condyle-ramus unit or had a condylar component replacing the resected condyles. Depending on the location of the defect, transport distraction was carried our anterior to posterior or posterior to anterior.

Results

A total of nine cases of benign mandibular pathologies were operated. Segmental resection with condylar preservation was carried out in seven cases, segmental resection with condylar resection was carried out in two cases. In cases with condylar resection, the reconstruction plate of the distractor device had a condylar component. Anterior to posterior transport distraction was carried out in seven cases, and posterior to anterior transport distraction carried out in two cases. The amount of distracted bone ranged from 38 to 46 mm.

Conclusion

Mandibular transport distraction osteogenesis offers a modality of reconstruction where the patient's native host bone is osteotomized and gradually distracted to induce the formation of regenerated osseous structure and soft tissue. Being cost-effective, not requiring a steep learning curve/long operative time, and not technically demanding as vascularized bone grafts/flaps, it is feasible in the Indian setup as a practical reconstructive option for benign jaw tumors.

Platelet-Rich Plasma for Treatment of Hair Loss Improves Patient-Reported Quality of Life

BACKGROUND

While numerous studies have demonstrated enhanced hair growth following platelet-rich plasma (PRP) treatments in patients with male and female pattern hair loss, no study has demonstrated its impact on quality of life (QoL) using a validated tool.

OBJECTIVE

This prospective study aimed to assess the psychological impact of PRP treatment for hair loss.

METHODS

PRP scalp injections were repeated monthly for the first 3 months, then quarterly for 1 year, and annually thereafter. HAIRDEX 48, a validated scale assessing QoL for patients with alopecia, was administered before PRP and at each visit. Scores were interpolated on a 0-100 scale: 0 representing highest QoL, 100 lowest, and compared using paired t-tests.

RESULTS

Ninety-two patients receiving PRP were analyzed. Mean age was 48.2 ± 17.4 years and 55% were male. Patients had an average of 4 ± 2 treatments; most (60%) had ≥4. Thirty patients (33%) completed both pre- and post-PRP questionnaires. Prior to PRP, 61% tried minoxidil, 16% finasteride, and 1% hair transplant. Total HAIRDEX scores improved from a mean of 23.2 ± 15.4 to 19.7 ± 11.3 after 3-5 months after PRP (p < 0.001). There were also decreases in symptoms (10.0 ± 12.0 vs. 9.6 ± 10.8, p < 0.001), functioning (16.1 ± 18.1 vs. 13.3 ± 12.6, p < 0.001), and emotions domains (37.7 ± 24.1 vs. 32.2 ± 18.9, p < 0001). For stigmatization and self-confidence domains, improvements from pre-PRP were significant at 3-5 months (21.2 ± 16.8 vs. 17.4 ± 12.1; p < 0.001 and 24.8 ± 17.7 vs. 20.9 ± 15.5; p < 0.001, respectively) and >6 months (18.9 ± 13.9; p < 0.001 and19.5 ± 18.6; p = 0.008, respectively).

CONCLUSIONS

PRP improves QoL and is an effective part of multimodal therapy for hair loss.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Evaluation of injectable platelet-rich fibrin produced by a simple twice-centrifugation method combined with vacuum sealing drainage technology in the treatment of chronic refractory wounds

Objective: To evaluate the effects of injectable platelet-rich fibrin (i-PRF) produced by a simple twice-centrifugation method combined with vacuum sealing drainage on wound inflammation and scar formation in chronic refractory wounds (CRW).

Methods: A total of sixty-eight patients with CRW who were admitted to our hospital were enrolled in this study. They were then randomly divided into the study group (n = 34) with being treated using negative pressure sealing and drainage technology, and the control group (n = 34) with being treated using injectable platelet-rich fibrin in conjunction with negative pressure sealing and drainage technology. The following were the primary outcomes: scar conditions at 1 and 3 months after the wound was fully healed, wound healing time, hospitalization time, wound healing rate, incidence of adverse reactions, serum inflammatory indices, and pain levels were assessed 1 day before treatment and 14 days after treatment. The secondary outcomes were determined by comparing the proportion of positive bacterial cultures in the two groups on the day before therapy, as well as on the seventh and fourteenth days after treatment.

Results: The wound healing time and hospital stay in the study group were significantly lower than that in the control group (all p < 0.001). The wound healing rate of the study group was significantly higher than that of the control group on the 14th day and 28th day after treatment (all p < 0.001). On the 14th day after treatment, the levels of WBC, CRP, and IL-6 in the study group were lower than those in the control group (all p < 0.001). The positive rate of bacterial culture in the study group was significantly lower than that in the control group on the 7th and 14th day after treatment (all p < 0.05). At 1 month and 3 months after treatment, the VSS score in the study group was lower than that in the control group (all p < 0.001). The total defect rate of the study group was also significantly lower than that of the control group (5.88% vs. 29.41%, p = 0.011).

Conclusion: The i-PRF produced by simple twice-centrifugation method combined with VSD could reduce wound inflammation and improve scar formation in patients with CRW.

Pro-angiogenic approach for skeletal muscle regeneration

The angiogenesis process is a phenomenon in which numerous molecules participate in the stimulation of the new vessels' formation from pre-existing vessels. Angiogenesis is a crucial step in tissue regeneration and recovery of organ and tissue function. Muscle diseases affect millions of people worldwide overcome the ability of skeletal muscle to self-repair. Pro-angiogenic therapies are key in skeletal muscle regeneration where both myogenesis and angiogenesis occur. These therapies have been based on mesenchymal stem cells (MSCs), exosomes, microRNAs (miRs) and delivery of biological factors. The use of different calls of biomaterials is another approach, including ceramics, composites, and polymers. Natural polymers are use due its bioactivity and biocompatibility in addition to its use as scaffolds and in drug delivery systems. One of these polymers is the natural rubber latex (NRL) which is biocompatible, bioactive, versatile, low-costing, and capable of promoting tissue regeneration and angiogenesis. In this review, the advances in the field of pro-angiogenic therapies are discussed.

Platelet-Rich Fibrin Can Neutralize Hydrogen Peroxide-Induced Cell Death in Gingival Fibroblasts

Hydrogen peroxide is a damage signal at sites of chronic inflammation. The question arises whether platelet-rich fibrin (PRF), platelet-poor plasma (PPP), and the buffy coat can neutralize hydrogen peroxide toxicity and thereby counteract local oxidative stress. In the present study, gingival fibroblasts cells were exposed to hydrogen peroxide with and without lysates obtained from PRF membranes, PPP, heated PPP (75 °C for 10 min), and the buffy coat. Cell viability was examined by trypan blue staining, live-dead staining, and formazan crystal formation. Cell apoptosis was assessed by cleaved caspase-3 Western blot analysis. Reverse transcription-quantitative polymerase chain reaction (RT-PCR) was utilized to determine the impact of PRF lysates on the expression of catalase in fibroblasts. It was reported that lysates from PRF, PPP, and the buffy coat—but not heated PPP—abolished the hydrogen peroxide-induced toxicity in gingival fibroblasts. Necrosis was confirmed by a loss of membrane integrity and apoptosis was ruled out by the lack of cleavage of caspase-3. Aminotriazole, an inhibitor of catalase, reduced the cytoprotective activity of PRF lysates yet blocking of glutathione peroxidase by mercaptosuccinate did not show the same effect. PRF lysates had no impact on the expression of catalase in gingival fibroblasts. These findings suggest that PRF, PPP, and the buffy coat can neutralize hydrogen peroxide through the release of heat-sensitive catalase.