Fat grafting and platelet-rich plasma in wound healing: a review of histology from animal studies

Introduction: Autologous platelet-based concentrates represent increasingly popular adjuncts to a variety of medical, surgical and aesthetic interventions. Their beneficial potential rests on the ability to deliver a high concentration of growth factors to the target tissues. There are currently no reports in the literature appraising the evidence behind the use of platelet-rich plasma (PRP) in scar management. Methods: A detailed English literature review was conducted using PubMed Medline, Embase and Web of Science; the manuscripts were appraised and classified according to the Joanna Briggs Institute Levels of evidence. The results are presented in descending order of evidence separately for atrophic, keloid, surgical and traumatic scars. Discussion: On the basis of level 1 evidence currently available, it appears that PRP can improve the quality of atrophic acne scars treated with ablative fractional CO2 laser and decrease the duration of laser-related side effects including oedema and erythema. Regarding surgical scars, the current data suggest that PRP may improve wound healing and early scar quality; furthermore, incorporation of PRP in fat-grafting procedures undertaken in conjunction with non-ablative, fractional laser can contribute to better wound healing as well as a significant improvement in texture, colour and contour in traumatic scar resurfacing. There are no high level studies at present to support the incorporation of autologous platelet-based concentrates in the management of keloid scars. Conclusion: PRP is a promising adjunct in scar management practice. Further research with long-term follow-up is warranted to delineate the value of this modality in different subtypes of scars.

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Protocol for a systematic review of the efficacy of fat grafting and platelet-rich plasma for wound healing

Systematic Reviews ◽

10.1186/s13643-017-0505-8 ◽

2017 ◽

Vol 6 (1) ◽

Cited By ~ 8

Author(s):

Oliver J. Smith ◽

Muholan Kanapathy ◽

Ankur Khajuria ◽

Max Prokopenko ◽

Nadine Hachach-Haram ◽

...

Keyword(s):

Systematic Review ◽

Wound Healing ◽

Platelet Rich Plasma ◽

Fat Grafting

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Mandibular Third Molar Extraction Wound Healing With and Without Platelet Rich Plasma: A Comparative Prospective Study

Journal of Maxillofacial and Oral Surgery ◽

10.1007/s12663-014-0738-1 ◽

2015 ◽

Vol 14 (3) ◽

pp. 808-815 ◽

Cited By ~ 9

Author(s):

Shubha Ranjan Dutta ◽

Purnima Singh ◽

Deepak Passi ◽

Pradeep Patter

Keyword(s):

Wound Healing ◽

Prospective Study ◽

Platelet Rich Plasma ◽

Third Molar ◽

Third Molar Extraction ◽

Mandibular Third Molar ◽

Comparative Prospective Study ◽

Molar Extraction

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Systematic Review: Adipose-Derived Mesenchymal Stem Cells, Platelet-Rich Plasma and Biomaterials as New Regenerative Strategies in Chronic Skin Wounds and Soft Tissue Defects

International Journal of Molecular Sciences ◽

10.3390/ijms22041538 ◽

2021 ◽

Vol 22 (4) ◽

pp. 1538 ◽

Cited By ~ 2

Author(s):

Pietro Gentile ◽

Simone Garcovich

Keyword(s):

Systematic Review ◽

Stem Cells ◽

Wound Healing ◽

Soft Tissue ◽

Chronic Wounds ◽

Platelet Rich Plasma ◽

Skin Wounds ◽

Soft Tissue Defects ◽

Chronic Skin ◽

Tissue Defects

The number of clinical trials evaluating adipose-derived mesenchymal stem cells (AD-MSCs), platelet-rich plasma (PRP), and biomaterials efficacy in regenerative plastic surgery has exponentially increased during the last ten years. AD-MSCs are easily accessible from various fat depots and show intrinsic plasticity in giving rise to cell types involved in wound healing and angiogenesis. AD-MSCs have been used in the treatment of soft tissue defects and chronic wounds, employed in conjunction with a fat grafting technique or with dermal substitute scaffolds and platelet-rich plasma. In this systematic review, an overview of the current knowledge on this topic has been provided, based on existing studies and the authors’ experience. A multistep search of the PubMed, MEDLINE, Embase, PreMEDLINE, Ebase, CINAHL, PsycINFO, Clinicaltrials.gov, Scopus database, and Cochrane databases has been performed to identify papers on AD-MSCs, PRP, and biomaterials used in soft tissue defects and chronic wounds. Of the 2136 articles initially identified, 422 articles focusing on regenerative strategies in wound healing were selected and, consequently, only 278 articles apparently related to AD-MSC, PRP, and biomaterials were initially assessed for eligibility. Of these, 85 articles were excluded as pre-clinical, experimental, and in vitro studies. For the above-mentioned reasons, 193 articles were selected; of this amount, 121 letters, expert opinions, commentary, and editorials were removed. The remaining 72 articles, strictly regarding the use of AD-MSCs, PRP, and biomaterials in chronic skin wounds and soft tissue defects, were analyzed. The studies included had to match predetermined criteria according to the patients, intervention, comparator, outcomes, and study design (PICOS) approach. The information analyzed highlights the safety and efficacy of AD-MSCs, PRP, and biomaterials on soft tissue defects and chronic wounds, without major side effects.

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In vitro and in vivo Effect of Platelet-Rich Plasma-Based Autologous Topical Serum on Cutaneous Wound Healing

Skin Pharmacology and Physiology ◽

10.1159/000517195 ◽

2021 ◽

pp. 1-13

Author(s):

Eduardo Anitua ◽

Victoria Muñoz ◽

Libe Aspe ◽

Roberto Tierno ◽

Adrian García-Salvador ◽

...

Keyword(s):

Wound Healing ◽

Tissue Damage ◽

Collagen Synthesis ◽

Dermal Fibroblast ◽

Platelet Rich Plasma ◽

Cell Activity ◽

Cutaneous Wound Healing ◽

Cutaneous Wound ◽

Fibroblast Migration ◽

Edge Contraction

Introduction: Skin injury and wound healing is an inevitable event during lifetime. However, several complications may hamper the regeneration of the cutaneous tissue and lead to a chronic profile that prolongs patient recovery. Platelet-rich plasma is rising as an effective and safe alternative to the management of wounds. However, this technology presents some limitations such as the need for repeated blood extractions and health-care interventions. Objective: The aim of this study was to assess the use of an endogenous and storable topical serum (ES) derived from plasma rich in growth factors promoting wound healing, and to obtain preliminary data regarding its clinical and experimental effect over ulcerated skin models and patient care. Methods: Human dermal fibroblast and 3D organotypic ulcerated skin models were used to assess ES over the main mechanisms of wound healing including cell migration, edge contraction, collagen synthesis, tissue damage, extracellular matrix remodeling, cell death, metabolic activity, and histomorphometry analysis. Additionally, 4 patients suffering from skin wounds were treated and clinically assessed. Results: ES promoted dermal fibroblast migration, wound edge contraction, and collagen synthesis. When topically applied, ES increased collagen and elastin deposition and reduced tissue damage. The interstitial edema, structural integrity, and cell activity were also maintained, and apoptotic levels were reduced. Patients suffering from hard-to-heal wounds of different etiologies were treated with ES, and the ulcers healed completely within few weeks with no reported adverse events. Conclusion: This preliminary study suggests that ES might promote cutaneous wound healing and may be useful for accelerating the re-epithelization of skin ulcers.

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The Effect of Platelet-Rich Plasma on the Intra-Articular Microenvironment in Knee Osteoarthritis

International Journal of Molecular Sciences ◽

10.3390/ijms22115492 ◽

2021 ◽

Vol 22 (11) ◽

pp. 5492

Author(s):

Dawid Szwedowski ◽

Joanna Szczepanek ◽

Łukasz Paczesny ◽

Jan Zabrzyński ◽

Maciej Gagat ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Operative Treatment ◽

Animal Studies ◽

Platelet Rich Plasma ◽

Treatment Options ◽

Treatment Protocols ◽

Metabolic Functions ◽

Inflammatory Drugs ◽

Positive Effect

Knee osteoarthritis (KOA) represents a clinical challenge due to poor potential for spontaneous healing of cartilage lesions. Several treatment options are available for KOA, including oral nonsteroidal anti-inflammatory drugs, physical therapy, braces, activity modification, and finally operative treatment. Intra-articular (IA) injections are usually used when the non-operative treatment is not effective, and when the surgery is not yet indicated. More and more studies suggesting that IA injections are as or even more efficient and safe than NSAIDs. Recently, research to improve intra-articular homeostasis has focused on biologic adjuncts, such as platelet-rich plasma (PRP). The catabolic and inflammatory intra-articular processes that exists in knee osteoarthritis (KOA) may be influenced by the administration of PRP and its derivatives. PRP can induce a regenerative response and lead to the improvement of metabolic functions of damaged structures. However, the positive effect on chondrogenesis and proliferation of mesenchymal stem cells (MSC) is still highly controversial. Recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, significant progress has been made in understanding the mechanism of PRP action. In this review, we will discuss mechanisms related to inflammation and chondrogenesis in cartilage repair and regenerative processes after PRP administration in in vitro and animal studies. Furthermore, we review clinical trials of PRP efficiency in changing the OA biomarkers in knee joint.

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Variation in platelet‐rich plasma compositions used for wound healing indications

Wound Repair and Regeneration ◽

10.1111/wrr.12886 ◽

2020 ◽

Author(s):

Ivo Bijl ◽

Dirk Korte ◽

Esther Middelkoop

Keyword(s):

Wound Healing ◽

Platelet Rich Plasma

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Preparation of biocompatible wound dressings with dual release of antibiotic and platelet-rich plasma for enhancing infected wound healing

Journal of Biomaterials Applications ◽

10.1177/0885328221996013 ◽

2021 ◽

pp. 088532822199601

Author(s):

Linying Shi ◽

Fang Lin ◽

Mou Zhou ◽

Yanhui Li ◽

Wendan Li ◽

...

Keyword(s):

Wound Healing ◽

Wound Dressing ◽

Platelet Rich Plasma ◽

Healing Process ◽

Wound Dressings ◽

Inflammatory Factors ◽

Gelatin Microspheres ◽

Infected Wounds ◽

Dual Release

The ever-growing threats of bacterial infection and chronic wound healing have provoked an urgent need for novel antibacterial wound dressings. In this study, we developed a wound dressing for the treatment of infected wounds, which can reduce the inflammatory period (through the use of gentamycin sulfate (GS)) and enhance the granulation stage (through the addition of platelet-rich plasma (PRP)). Herein, the sustained antimicrobial CMC/GMs@GS/PRP wound dressings were developed by using gelatin microspheres (GMs) loading GS and PRP, covalent bonding to carboxymethyl chitosan (CMC). The prepared dressings exhibited high water uptake capability, appropriate porosity, excellent mechanical properties, sustain release of PRP and GS. Meanwhile, the wound dressing showed good biocompatibility and excellent antibacterial ability against Gram-negative and Gram-positive bacteria. Moreover, in vivo experiments further demonstrated that the prepared dressings could accelerate the healing process of E. coli and S. aureus-infected full-thickness wounds i n vivo, reepithelialization, collagen deposition and angiogenesis. In addition, the treatment of CMC/GMs@GS/PRP wound dressing could reduce bacterial count, inhibit pro-inflammatory factors (TNF-α, IL-1β and IL-6), and enhance anti-inflammatory factors (TGF-β1). The findings of this study suggested that biocompatible wound dressings with dual release of GS and PRP have great potential in the treatment of chronic and infected wounds.

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