scholarly journals Efficacy of autologous platelet-rich plasma on graft uptake in myringoplasty: a single-blinded randomized control trial

2022 ◽  
Vol 38 (1) ◽  
Author(s):  
R. Vignesh ◽  
V. Nirmal Coumare ◽  
S. Gopalakrishnan ◽  
P. Karthikeyan

Abstract Background and aim Chronic otitis media is defined as a chronic inflammation of the middle ear cleft producing irreversible pathological changes. The myringoplasty aims at the reconstruction of the tympanic membrane using a graft material. Autologous platelet-rich plasma can be used along with the graft to have a successful outcome. The aim of the study was to assess the efficacy of autologous platelet-rich plasma on graft uptake in myringoplasty. Methods This was a randomized controlled trial with a sample size of 76 patients. All patients were above 18 and below 55 years of age diagnosed with chronic suppurative otitis media and were planned for myringoplasty. The participants were randomly allotted to two groups by block randomization (block of 4). Intra-operatively, group I (n=38) received platelet-rich plasma–soaked gel foam and group II (n=38) was taken as the control group who received saline-soaked gel foam and examined by a blinded examiner at the end of 1st and 3rd months. Results The mean air-bone gap reduction post-operatively in the platelet-rich plasma group was 8.68 ± 4.8 (P value 0.034) and 6.05 ± 4.05 in the control group. The improvement in pure-tone average in the platelet-rich plasma group (P = 0.009) is more than that in the control group. The graft uptake was higher among the platelet-rich plasma group than the control group both at 1st and 3rd months (P value 0.049) which were statistically significant. Conclusion The present study concludes that the usage of platelet-rich plasma in the conventional myringoplasty technique has improved the success rate of graft uptake and reduced the graft migration. Trial registration Clinical Trials Registry-India (ICMR-NIMS) CTRI/2020/04/024416. Date of registration: 01/04/2020. Date of enrolment of the first participant to the trial: 06/04/2020. URL of the trial registry: http://www.ctri.nic.in. Highlights Usage of autologous platelet-rich plasma (PRP) in conventional myringoplasty in underlay technique. Assessment of graft uptake, percentage of perforation closure, and the audiological outcome. Significant mean reduction of ABG in the PRP group. Significant improvement in PTA average in the PRP group. Graft uptake and percentage of perforation closure were higher in the PRP group and the control group. PRP is also beneficial in revision cases.

2021 ◽  
Vol 26 (2) ◽  
pp. 150-157
Author(s):  
R. R. Farkhshatova ◽  
L. P. Gerasimova ◽  
I. T. Yunusov

Relevance. It is currently relevant to study and compare the effectiveness of the autologous connective tissue grafts and the combination of collagen-based and autologous platelet-rich plasma in the surgical treatment of Miller Class I gingival recessions.Materials and methods. We examined and treated 48 (20 male (41.67%) and 28 female (58.33%)) patients aged from 25 to 40 years with Miller Class I gingival recessions. All gingival recessions were treated surgically using a modified twolayer tunnel technique. The patients were divided into two groups according to the graft type. Group I (24 patients (50%) had a connective tissue graft from the hard palate. Group II (24 patients (50%) used the combination of the autologous platelet-rich plasma and 3D collagen matrix Fibromatrix for the regeneration of oral soft tissues. We removed the sutures on the 14th day. The patients were followed up on the 7th and 14th days and in 1.3 months.Results. 48 Miller Class I gingival recessions were treated between 2018 and 2020. The depth of gingival recessions averaged 3.5 ± 1.13 mm before treatment. The level of the attached keratinized gingiva regarding the cementoenamel junction significantly (p < 0.001) improved in both groups after the surgery. The width and thickness of the keratinized gingiva best increased in group II. The mean effectiveness of gingival recession treatment was 84% in study group I and 96% – in study group II. Pain syndrome, fibrinous plaque and soft tissue edema were insignificant in group II.Conclusion. The combination of the autologous platelet-rich plasma and Fibromatrix, collagen 3D matrix, for the regeneration of the oral soft tissues is a more effective technique for the treatment of Miller Class I gingival recessions. This technique has several advantages. It is minimally invasive, less painful, soft tissue postoperative swelling is less and the received volume of the attached keratinized gums is larger than with a connective tissue graft. 


2012 ◽  
Vol 23 (5) ◽  
pp. 1318-1323 ◽  
Author(s):  
Gregory Faratzis ◽  
Minas Leventis ◽  
Evanthia Chrysomali ◽  
Lubna Khaldi ◽  
Areti Eleftheriadis ◽  
...  

Author(s):  
Ya.V. Rybalka

Introduction. The analysis of the effectiveness of applying autologous platelet-rich plasma was performed in order to improve the results of surgical treatment of patients with wounds that heal slowly. Materials. The study is based on the analysis of the treatment of 61 patients who suffered from slow-healing wounds of venous genesis with a diameter of no more than 8 cm on the lower extremities and took the treatment at the surgical ward. The proposed method was based on obtaining autologous enriched platelet plasma followed by its injection along the periphery of the wound. The degree of reduction of the wound surface area was assessed by the method of contact planimetry per day. The patients of the 1st group demonstrated the wound area reduction by 5.1 ± 0.6%, and the patients of the group 2 – by 1.8 ± 0.4% (p <0005). The results indicate an increase in the rate of wound healing in patients in group 1 compared with patients in group 2. During the entire follow-up period (12 weeks), complete wound epithelialisation occurred in 21 (70%) patients in group 1 and in 10 (33.3%) patients of the group 2. The wound area decreased by more than 50% in 6 patients of group 1 (20%) and in 2 (7%) patients of the control group. The wound area decreased less than by 50% in 3 patients in group 1 (10%), and in 19 patients in group 2 (60%). The use of PRP therapy has been proven to have a significant positive effect on the process of wound healing compared with the use of standard methods used for the control group. Conclusion: increase in the wound healing pace in patients of group 1 (test) compared with patients of group 2 (control) can be explained by using autologous platelet-enriched plasma as an additional means to the standard therapy.


Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 409-412
Author(s):  
Karina Karina ◽  
Krista Ekaputri ◽  
Johannes Albert Biben ◽  
Imam Rosadi ◽  
Iis Rosliana ◽  
...  

Introduction and Aim: Activated autologous platelet-rich plasma (aaPRP) is becoming a popular therapy to accelerate healing in the field of plastic surgery. Platelets, which are abundant in aaPRP, can release many growth factors including platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF). This study aims to examine the plasma levels of PDGF and VEGF in healthy subjects after intravenous administration of aaPRP.   Materials and Methods: Nine healthy patients with no prior history of metabolic disease were divided into two groups (control and experiment group). The treatment group which consists of six patients received intravenous aaPRP treatment. The preparation of aaPRP starts with the collection of 24 mL of whole blood in sodium citrate tubes followed a two-step centrifugation procedure and subsequent chemical activation. aaPRP was then administered intravenously to patients. Meanwhile, the control group received no intervention. Venous blood samples were taken before and one week after the treatment and the plasma PDGF and VEGF levels were determined by enzyme-linked immunosorbent assay (ELISA).   Results: The treatment group showed statistically significant increase in VEGF after 7 days compared to before aaPRP administration. However, the change in PDGF levels of the treatment group was unnotable.   Conclusion: The present findings indicate that intravenous administrations of activated aaPRP may increase plasma VEGF level up to 1 week after aaPRP administration.


2017 ◽  
Vol 203 (6) ◽  
pp. 327-338 ◽  
Author(s):  
Min Wook Joo ◽  
Seung Jae Chung ◽  
Seung Han Shin ◽  
Yang-Guk Chung

To develop a clinically effective bone regeneration strategy, we compared bone regeneration using allogeneic cancellous bone granule scaffolds loaded with autologous bone marrow-derived mesenchymal stem cells (BM-MSC) with or without autologous platelet-rich plasma (PRP). Critical-sized segmental bone defects were made at the mid-shaft of both radiuses in 41 New Zealand White rabbits. Small-sized allogeneic cancellous bone granules (300-700 μm in diameter) loaded with BM-MSC were implanted on one side, and PRP was added. On the other side, autologous BM-MSC loaded onto allogeneic cancellous granules were grafted as a control. Bone regeneration was assessed by radiographic evaluation at 4, 8, and 16 weeks postimplantation and by micro-computed tomography (micro-CT) and histological evaluation of the retrieved specimens at 8 and 16 weeks. The experimental group did not show significantly higher bone quantity indices than the control group at any time point. Micro-CT analysis revealed that both groups had similar mean total volumes, surface areas, and other parameters at 8 and 16 weeks. Histological evaluation of 8- and 16-week specimens also showed a similar progression of new bone formation and maturation. In this experiment using a contralateral control group in the same individual, an initial single addition of PRP in allogeneic cancellous bone granules loaded with BM-MSC for critical-sized bone defects in the weight-bearing area did not induce a consequent difference in bone healing. Further research into the optimal preparation and application of PRP is necessary. Furthermore, studies involving a greater number of subjects and larger experimental animals could determine the clinical relevance of PRP treatment.


2019 ◽  
Vol 6 (11) ◽  
pp. 4103
Author(s):  
Asif . ◽  
N. Chandramouli

Background: Chronic wounds are a frequent problem and pose a heavy burden to the service provider. Platelet extract containing several growth factors used on chronic wounds has shown impressive results in both healing percentage and time for epithelisation. Platelet extract from the patient’s own blood has been used in trials as a cheap and equally effective alternative to commercial platelet gels. The aim of the study was to demonstrate the therapeutic role of autologous platelet rich plasma (APRP) in epithelialisation and reduction in size of chronic wounds of lower limb.Methods: It is a case control study, conducted at Sri Adichunchanagiri Hospital and Research Centre, B.G. Nagara, Karnataka. Conducted during January 2017 to June 2018 this study consisted of 30 patients with chronic ulcers between the age group of 18-80 years, with duration of ulcer ranging from 12 to 26 weeks. After obtaining consent they were randomly allotted into control and test groups with 15 patients each. Control group patients were treated with conventional dressing and in test group APRP dressing was done. Later percentage decrease in wound size was assessed.Results: Ulcer size decreased significantly (p<0.0001) in test group compared to control group. No unwanted effects or complications noted.Conclusions: APRP is a safe and effective treatment modality for chronic non-healing ulcers. It enhances healing and also decreases the associated cost and morbidity. Further research and randomized controlled clinical trials on larger patient population are necessary to validate the results.


2021 ◽  
Vol 11 (5) ◽  
pp. 237-245
Author(s):  
V. D. Fundiur ◽  
V. K. Grodetskyi ◽  
S. O. Yakobchuk ◽  
O. Y. Khomko ◽  
I. M. Kozlovska ◽  
...  

Improvement of reparative process of the chronic wounds with the insufficiency of peripheral blood suppling in patients suffering from diabetes mellitus is an important issue requiring further investigation. An optimal choice of surgery, effective renewal of blood supply and active stimulation of tissue repair on the cellular level are essential components of success treatment of this problem.Objective of research: From 2017 to 2020, the efficiency of one of the variants of organ-saving surgery performed on 210 patients with an ischemic-gangrenous form of diabetic foot syndrome was studied.Materials and methods. Control group included 104 patients (49.52%), were the treatment carried out in accordance with the standard scheme. The main group (106 patients - 50.47%) in addition to the standard therapy have used regional ozone therapy, vacuum sanitization and local application of autologous platelet-rich plasma (APRP).Results. These proposed measures reduced the period of clinical treatment to 24±1,2 days in the main group compared to 37±2,4 in the control one. 2 years later, patients of the main group confirmed the formation of a foot stump functionally adapted for walking with angular dislocation of fragments of the cuboid and scaphoid bones.Two years after foot amputation due to the ischemic-gangrenous form of diabetic foot syndrome (DFS), the amount of repeated above knee amputations was 1.8 times higher in the control group in comparison with the main group, which is indicative of a reasonable use of the complex of activate a reparative process in the wound.Conclusions: The suggested modification of the organ-saving and partial foot amputation in patients with IV degree of ischemia and DFS is indicative of a possibility to perform such kind of surgery as a variant of choice.The complex of proposed additional measures including regional ozone therapy, vacuum sanitization and local administration of autologous platelet-rich plasma activates a reparative process of a chronic foot wound and promotes an effective treatment of patients with ischemic-gangrenous form of DFS.


2019 ◽  
Vol 12 (2) ◽  

The purpose of this study was to evaluate the effects of an autologous platelet rich-plasma on femoral fracture healing in experimentally induced rabbits’ model. In this study, 34 local breed rabbits, around 2-2.5 kg body weight, were divided into two equal groups randomly; Group A: platelet-rich plasma (PRP) and Groups B: Control group. Rabbits in both groups underwent a complete mid-shaft transverse osteotomy of the femur by a fine electrical saw. After fracture induction, the rabbits in group A (PRP group) were treated by application of 0.5 ml of autologous PRP at the site of the fractured bone, while in group B (control), rabbits were injected with distilled water. Samples from the fractured femur were collected at 10th, 20th, 30th days post operation for radiological evaluation and at 10th, 14th, 20th, and 30th days for histopathological evaluation. In radiological study, it was found that the rate of callus formation in rabbits treated with PRP (Group A) were faster than the control group (Group B) at different periods. Similarly, in histological finding it found that the stages of healing were faster in Group A when compared with Group B. It was concluded that using autologous PRP has beneficial effect to enhance the process of bone healing in the rabbit’s model.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hesham Adel Alaa Aldein ◽  
Wafi Fouad Salib ◽  
Ramy Mikhael Nageeb ◽  
Abdelrahman Ahmed Mohamed ◽  
Ahmad Farid Elsayed Mostafa Radwan

Abstract Background Prevalence of active venous leg ulcers was reported to be around 0.5% in different populations severely reduces quality of life, and increases the cost of health care. Management of VLUs include many modalities to obtain good result and improving patients life-style, these modalities include compression therapy, medical treatment, surgical and interventional procedures and local wound care. Objective: To compare between autologous platelet rich plasma and saline dressing in treatment of chronic leg venous ulcer concerning reduction of ulcer area. Patients and Methods That prospective study included 40 patients with chronic venous leg ulcers recruited from Ain shams university hospitals for whom treatment with PRP was done for 20 patients weekly for up to 3 weeks(one session of injection per week)(study group) and applying saline dressing for 20 patients(control group) in addition to compression therapy and follow up for4 months. Our objective was to compare rate of wound healing. Results A total of 44 venous ulcers from 40 patients who met the inclusion criteria were treated. Application of PRP was done for 20 patients weekly for up to 3 weeks(one session of injection per week)(study group) and applying saline dressing for 20 patients(control group) in addition to compression therapy and follow up for4 months. Conclusion We can draw the conclusion our study's results reveal that the use of PRP contributes to improving the results of treatment of venous ulcers and that it is an effective and safe therapy. Nonetheless, we need to consider that application of this or any other treatment should always be accompanied by the necessary management of the underlying disease, in addition to a suitable pressure bandage that improves venous return and facilitates favourable clinical course of lesions.


2019 ◽  
Vol 75 (08) ◽  
pp. 6285-2019
Author(s):  
MUSTAFA ARICAN ◽  
ATILLA ŞIMŞEK ◽  
KURTULUŞ PARLAK ◽  
KAMIL ATLI ◽  
GONCA SÖNMEZ

Osteoarthritis (OA) is a common cause of lameness, pain, and dysfunction in dogs. To determine the levels of interleukin (IL) (IL-1β, IL-6, IL-10), tumor necrosis factor (TNF)-α, and prostaglandin E2 (PG-E2) in the synovial fluid after intra-articular injection of an autologous platelet-rich plasma concentrate to treat dogs with osteoarthritis. Twenty dogs with osteoarthritis (OA) were used as a materials. Fourteen dogs were used as a platelet-rich plasma (PRP) treatment group and 6 dogs were used as a control (0.9 % NaCl). PRP was obtained by the double centrifuge method. Affected joints were examined by radiography and ultrasonography. Lameness and pain severity were evaluated by attending clinicians. Samples were collected under sterile conditions at pre-treatment, days 1, 3, 5, 7, 15, and weeks 4, 8, and 12. The marker levels were determined by an enzyme-linked immunosorbent assay. No adverse effects of the injection of platelet concentrate or saline solution were observed. No significant differences were found in the Hudson Visual Analog Scale and Canine Brief Pain Inventory scores between weeks 0, 4, and 12 in the control dogs. No significant changes were observed in IL-1β, IL-6, IL-10, TNF-α, and PG-E2 levels (P>0.05) in synovial fluid from the PRP treatment group compared to synovial fluid from the control group, although fluctuations in parameter levels were observed in both groups. Despite some variable results in inflammatory parameters, clinical improvement was recorded in the PRP-treated group. PRP injection could be an effective and safe method for treatment of dogs with osteoarthritis.


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