Management of a Patient with Colocutaneous Fistula by Autologous Platelet-rich Fibrin Glue

Osteoradionecrosis (ORN) of the jaws and medication-related osteonecrosis of the jaws (MRONJ) are uncommon but serious diseases affecting the oral and maxillofacial region with clinically similar appearance but distinct pathophysiology. Management of ORN and MRONJ is inherently challenging and the treatment outcomes are unpredictable. The use of autologous platelet concentrates (APCs) to promote hard and soft tissue healing is well described in the literature, and the efficacy of leucocyte and platelet-rich fibrin (L-PRF) has been well documented in a number of clinical studies. The aim of this study was to present our treatment strategy and the outcomes of incorporating L-PRF as a surgical adjunct in management of ORN and MRONJ in our centre. Methods: eight cases of ORN and MRONJ were treated with a combination of sequestrectomy and L-PRF as a surgical adjunct. Results: the overall success was 87.5%. Using L-PRF as an adjunct, we were able to predictably manage ORN and MRONJ without causing significant morbidity. Conclusion: our experience shows that L-PRF may be used as a valuable and cost-effective adjunct to surgical management of ORN and MRONJ. However, due to a limited number of patients, and a short period of review, the true effectiveness of the method is yet to be demonstrated in a longer follow-up study including a greater number of patients, besides the inclusion of a control group.

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Obsidian ASG® Autologous Platelet-Rich Fibrin Matrix and Colorectal Anastomotic Healing: A Preliminary Study

Surgical Technology Online ◽

10.52198/21.sti.39.cr11508 ◽

2021 ◽

Vol 39 ◽

Author(s):

Andreas Shamiyeh ◽

◽

Bettina Klugsberger ◽

Carina Aigner ◽

Wolfgang Schimetta ◽

...

Keyword(s):

Anastomotic Leakage ◽

Anastomotic Leak ◽

Colorectal Resection ◽

Rectal Resection ◽

Leak Rate ◽

Anastomotic Healing ◽

Platelet Rich Fibrin ◽

Anastomotic Leak Rate ◽

Fibrin Matrix ◽

Autologous Platelet

Introduction: Anastomotic leakage (AL) following colorectal resection is a devastating complication affecting morbidity, mortality, and quality of life of patients in the long term. Different tissue sealants and biologic glues were tested showing conflicting results regarding their influence on anastomotic healing and leak prevention. Application of autologous platelet-rich fibrin (Vivostat A/S, Alleroed, Denmark), which acts as a source of angiogenic growth factors and cytokines, showed promising results in an in-vivo porcine model. Herein, we present the first human study of stapled colorectal anastomoses supplemented with an autologous-derived platelet-rich fibrin matrix (Obsidian ASG®, Rivolution GmbH, Rosenheim, Germany and Vivostat A/S, Alleroed, Denmark). Materials and Methods: A retrospective analysis of prospectively accumulated data was performed in two colorectal centers (Linz, Vienna) on patients undergoing left-sided colorectal or coloanal stapled anastomosis between October 2018 and December 2019. The Obsidian ASG® Matrix was applied to the rectal stump, and after closure with the circular stapling device, at the circumference of anastomosis in every single case. Anastomoses were supplemented with intra- and extra-anastomotic application (IAA—intra-anastomotic application developed by Rivolution GmbH, Rosenheim, Germany) of Obsidian ASG® Matrix. The primary endpoints were incidence of perioperative complications and anastomotic leak rate. Results: Two-hundred-sixty-one (138 female) patients underwent left-sided colonic (n=177) or rectal resection (n=84). In 253 (96.9%) cases, a laparoscopic or robotic-assisted approach was used. There were no complications attributable to the intraoperative application of the Obsidian ASG® Matrix. All intraoperative leak tests were negative. Overall, anastomotic leak rate accounted for 2.3% (6/261). AL following colonic and rectal resection was seen in 2.3% (4/177) and 2.4% (2/84), respectively. Complication and leak rate was similar in the two participating centers. Postoperative fever and elevated CRP levels were significantly correlated to AL. There was no significant risk factor for AL on multivariate analysis. Conclusion: Application of an autologous-derived platelet-rich fibrin matrix (Obsidian ASG®) at anastomotic site following colorectal resection is safe and associated with a low rate of anastomotic leakage.

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Local Application of Autologous Platelet-Rich Fibrin Patch (PRF-P) Suppresses Regulatory T Cell Recruitment in a Murine Glioma Model

Molecular Neurobiology ◽

10.1007/s12035-018-1430-0 ◽

2018 ◽

Vol 56 (7) ◽

pp. 5032-5040 ◽

Cited By ~ 6

Author(s):

Wojciech K. Panek ◽

Katarzyna C. Pituch ◽

Jason Miska ◽

Julius W. Kim ◽

Aida Rashidi ◽

...

Keyword(s):

T Cell ◽

Regulatory T Cell ◽

Local Application ◽

Cell Recruitment ◽

Platelet Rich Fibrin ◽

Glioma Model ◽

Autologous Platelet ◽

Murine Glioma

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Obtention of injectable platelets rich-fibrin (i-PRF) and its polymerization with bone graft: technical note

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-69912015006013 ◽

2015 ◽

Vol 42 (6) ◽

pp. 421-423 ◽

Cited By ~ 27

Author(s):

Carlos Fernando de Almeida Barros Mourão ◽

Helder Valiense ◽

Elias Rodrigues Melo ◽

Natália Belmock Mascarenhas Freitas Mourão ◽

Mônica Diuana-Calasans Maia

Keyword(s):

Bone Graft ◽

Platelet Rich Plasma ◽

Technical Note ◽

Platelet Concentrates ◽

Soft Tissue Healing ◽

Liquid Form ◽

Platelet Rich Fibrin ◽

Tissue Healing ◽

Autologous Platelet ◽

Injectable Form

The use of autologous platelet concentrates, represent a promising and innovator tools in the medicine and dentistry today. The goal is to accelerate hard and soft tissue healing. Among them, the platelet-rich plasma (PRP) is the main alternative for use in liquid form (injectable). These injectable form ofplatelet concentrates are often used in regenerative procedures and demonstrate good results. The aim of this study is to present an alternative to these platelet concentrates using the platelet-rich fibrin in liquid form (injectable) and its use with particulated bone graft materials in the polymerized form.

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