Why dilute the regenerative power of platelet-rich plasma?

What Is the Adequate PRP Dose for an Effective Treatment? An In Vitro Experimental Study on the Skin

BACKGROUND

The clinical results of many studies on platelet-rich plasma (PRP) differ due to a lack of standardization in PRP preparation and administration as well as many variables such as PRP preparation methods, platelet concentration, and platelet activation.

OBJECTIVES

The authors sought to investigate a different variable that will affect PRP application results. How much PRP should be injected into the unit area of tissue for an effective PRP treatment?

METHODS

The study was performed on fresh surplus tissues of 20 patients that were discarded in abdominoplasty and mammoplasty operations. Nine areas of 4 cm2 were marked on the skin. Fluorescein-stained PRP was injected intradermally with 3 different gauge needles at 3 different doses (0.01, 0.03, and 0.05 mL). After injections, spreads of the fluorescent dye-covered areas in horizontal and vertical planes were measured and compared. For the horizontal plane measurements, the dye spread was measured first from the surface of the skin and second from the dermal surface of the skin. In addition, the width and depth of the dye spread in the dermis were measured from vertical sections.

RESULTS

Changing the needle diameter does not affect the width or depth (thickness) of the PRP spread in the dermis. Increasing the applied dose to 0.03 mL increases the spread to the width and depth (thickness).

CONCLUSIONS

In research evaluating the effectiveness of PRP treatments, it is necessary to report the volume of PRP to be applied per unit of tissue.

Does the use of Dermojet affect the concentration of platelet-rich plasma? An in vitro experimental investigation

Needle-free injection systems with high jet pressure have been used for seven decades for drug or vaccine administration via intradermal, subcutaneous, and intramuscular routes. These systems are used for the application of mesotherapy drugs in plastic surgery and dermatology. Platelet-rich plasma (PRP) tissue regeneration is applied intradermally by a needle for different indications, such as wound healing and scar revision. To prevent complaints such as pain, erythema, and ecchymosis by patients during this application, PRP was applied using Dermojet, a jet injector system with a spring-loaded system. In this study, after measuring the average platelet count in PRP preparations obtained from 18 volunteers, a 2.5 cc PRP shot into an empty tube was performed with Dermojet. The mean platelet count was measured in a homogenized tube. The same procedures were performed for platelet-poor plasma (PPP). The platelet loss rates for PRP and PPP were compared. In addition, the amount of PRP in each shot of the Dermojet was calculated. When PRP and PPP were applied using the Dermojet, platelet loss was 8.41% and 8.33%, respectively. The difference in the number of platelets formed in PRP and PPP when applied with Dermojet was not statistically significant. PRP application with needle-free injection systems, such as Dermojet, may be an alternative because of patient comfort and the negligible platelet loss compared with the PRP application with the standard needle injection.