PRP - Platelet Rich Plasma: What is it? What is it for?

 

PRP - Platelet Rich Plasma: What is it? What is it for?

 

The PRP - platelet rich plasma is a blood-derived product, characterized by high concentration of growth factors . The Platelet-Rich Plasma , English word from which the acronym PRP, is used for therapeutic purposes, for its unique ability to stimulate and facilitate tissue regeneration , in different medical areas ranging from orthopedics to plastic surgery.

 

As the term suggests, Platelet-Rich Plasma is made up of plasma with a higher concentration of platelets than is found in normal blood . It is, in fact, a completely natural blood-derived substance, which is obtained by centrifugation, after the withdrawal of a limited amount of blood from the patient himself (we speak, in fact, of autologous origin of the PRP: this means that, as in transfusions blood or other methods, donor and recipient are the same person).

 

Treatment with Platelet Rich Plasma (PRP) normally involves one or more infiltrations in the affected site.

 

What's this
 

The Platelet Rich Plasma (commonly indicated with the "PRP" acronym) is one of blood-derived product , for use not transfusion, which for several years has found application in various branches of medicine. Platelet Rich Plasma is also known as platelet gel or platelet jelly .

 

How does the PRP work?


Platelet Rich Plasma - PRP is a platelet concentrate that exploits the action of autologous growth factors (ie belonging to the same patient) obtained from the centrifugation of blood, following a simple sampling.

 

Preliminary notions: platelets and growth factors



The platelets (or thrombocytes) are elements of the blood products from the bone marrow , whose main function is related to the process of coagulation and hemostasis. However, these are also a "reservoir" of growth factors , which play a fundamental role in tissue repair, in response to an injury of pathological or traumatic origin.


The growth factors (also known in English "shaped growth factor ") are proteins variously involved in stimulating cell proliferation and maturation, in modulating the ' inflammation and in activating other cells , adjusting the' homeostasis tissue and are very important in wound healing and regenerative processes.


Platelet Rich Plasma: basic principle


The treatment is based on the concept that platelets, of which Platelet Rich Plasma is rich, release a wide range of mediators and other substances that promote tissue repair and influence the behavior of other cells, modulating inflammation and neoformation. of blood vessels .

It should be remembered, in fact, that platelets play a fundamental role in mediating the healing of damaged tissue , mainly thanks to the action of growth factors .

The knowledge of the importance and role of these factors has created a growing interest in their possible therapeutic use.

 

Key points

  • Platelet Rich Plasma (PRP) is a blood plasma concentrate , which contains approximately three to seven times the number of platelets found in normal circulating blood.
  • The therapeutic use of PRP is fundamentally based on the possibility of concentrating the platelet content to allow the increase in growth factors to accelerate tissue repair.
  • The increased concentration of platelets and growth factors present in Platelet Rich Plasma (PRP) represents an extraordinary natural stimulus to tissue repair .
  • What is it for

 

Platelets are capable of modulating physiological processes, favoring cell replication and the formation of a new extracellular matrix. This last property of theirs is interesting for treatments aimed at stimulating tissue regeneration.

 

The possible applications of PRP in the medical field are numerous. It should be noted, however, that not all the conditions for which the treatment is implemented have the same advantage; as for other therapeutic approaches, the result is affected by a certain subjectivity.

 

Is PRP treatment effective?
 

Platelet Rich Plasma (PRP) is mainly used in regenerative and plastic surgery, but, in clinical practice, numerous other applications have shown promise and are currently in the experimental phase.

Factors that can affect the effectiveness of PRP treatment include:

  • The area of ​​the body to be treated;
  • The general state of health of the patient;
  • Whether the injury is acute (e.g. sports injury) or chronic (if the injury develops over time).

 

The efficacy of Platelet Rich Plasma in certain fields of action is, in fact, a rather debated topic. In recent years, several scientific studies have been produced aimed at investigating and demonstrating the effectiveness of the application of PRP in the dental, orthopedic and aesthetic fields .

 

What conditions are treated with PRP?

 

  • Trauma and acute injuries : the infiltration of Platelet Rich Plasma is used in the treatment of sports injuries and acute injuries such as knee sprains , the ligament ruptures , the tearing and muscle strains . In orthopedics, PRP is used to accelerate the healing process of fractures and when applying prostheses;
  • Tendon injuries : PRP can accelerate the healing of a tendon after an injury (as a rule, this process occurs very slowly). The Platelet Rich Plasma infiltrations are also used to treat chronic wounds borne by the tendons , as in the case of:  tennis elbow , inflammation of the Achilles tendon or pain in the patellar tendon of the knee ;
  • Arthrosis : Platelet Rich Plasma-based therapies are applied for the management of degenerative orthopedic diseases, such as osteoarthritis of the knee , hip and ankle ;
  • Post-surgical repair : In cardiac surgery, PRP is used to accelerate wound healing. 


PRP is also administered in the treatment of:

  • Burns and scars;
  • Bedsores ;
  • Vascular and diabetic ulcers;
  • Androgenetic alopecia ;
  • Dental implants and bone tissue reconstruction in the dental field;
  • Breast augmentation;
  • Correction of face defects.

What the treatment involves
How to get Platelet Rich Plasma


As anticipated, the Platelet Rich Plasma is an autologous substance that is obtained by centrifugation of venous blood taken of the same patient , against which it is envisaged the subsequent application. This preparation requires high precision: the aim of the method is to obtain the maximum possible platelet concentration, while preserving the vitality of the elements. Furthermore, the entire processing for obtaining Platelet Rich Plasma must comply with the quality and safety requirements imposed by the legislation. For this reason, at the end of the extraction and separation process, appropriate quality controls and microbiological tests are performed on a small sample of the PRP obtained.

Finally, the tubes containing the concentrate are stored in cold rooms suitable for use in the various planned treatment sessions.

 

Preparation phases of the PRP


1) Collection : a modest amount of blood is taken from the patient.

2) Centrifugation : the sample is placed in a special PRP-centrifuge which has characteristics dedicated to obtaining Platelet Rich Plasma. At the end of this operation, three layers are observed:

  • PPP - Low Platelet Plasma
  • PRP - Platelet Rich Plasma
  • Red blood cells


3) Separation : the platelet-poor plasma is aspirated and discarded from the PRP tube; PRP is isolated and combined, instead, with a platelet activator before administration , to be used for treatment.


PRP: what is the treatment?


The exact procedure clearly depends on the purpose of treatment and the scope of application, but the mode of administration is almost always injective. Generally, PRP is administered through a series of small inoculations in the area to be treated; it is therefore a minimally invasive procedure that can be performed after a mild local anesthesia. The treatment involves a cycle of sessions, at various intervals in time, in order to induce and maintain a significant stimulation.

 

Contraindications and Risks


Platelet Rich Plasma - PRP infiltrations have the advantage of using only autologous biological material, i.e. obtained from the patient's own blood, therefore:

  • Limit the chances of rejection;
  • It can speed up the post-operative course;
  • There is no danger of major complications, allergies or immunological reactions,
  • Furthermore, it is a fast and minimally invasive treatment, which is carried out in less than an hour and allows the patient to immediately resume his normal activities.

It should be remembered that not all people are able to benefit from Platelet Rich Plasma therapy; the possible and real effects of the treatment should be discussed with your doctor. It should also be considered that the need to integrate PRP stimulation with other therapeutic strategies is not excluded. In some cases, for example, the association of PRP and hyaluronic acid may be indicated .

Are there any contraindications to PRP?
 

Platelet Rich Plasma treatment is contraindicated in some conditions, i.e. in the presence of blood clotting disorders , acute infectious diseases and haematological tumors.

As for the side effects, the risks are minimal and essentially reside in the method of administration, which is almost always injective.

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