The value of using platelet rich plasma during caesarian section to enhance wound healing in diabetic women

Author(s):  
Hany Hassan kamel
2020 ◽  
Vol 8 (A) ◽  
pp. 666-689
Author(s):  
Mary Moheb Ramzy ◽  
Tarik Ahmed Essawy ◽  
Ali Shamaa ◽  
Saher Sayed Ali Mohamed

Background: Delayed healing of diabetic wounds has been well-documented. Currently, the use of platelet-rich plasma (PRP) has attracted great attention in many medical fields including wound healing. Aim: Histological, immunohistochemical and ultrastructural evaluation of the effect of PRP on wound healing in the tongue of normal and Streptozotocin-induced diabetic albino rats. Methodology: A total number of 108 adult male albino rats with average weight 200gm, were used in the study. The animals were classified into two main groups: non-diabetic and diabetic groups. Each group was further divided into three subgroups: non- treated wound, PRP-treatment before wound, and PRP-treatment after wound. Tongue specimens were dissected on postoperative days 1, 3, and 7. The specimens were examined histologically by H&E, immunohistochemically by p63 and vimentin, and ultra-structurally by TEM. Results:  The most accelerated wound healing was revealed in the subgroups treated with PRP before the wound, whether non-diabetic or diabetic, which occurred very early at the 3rd day postoperative in both cases. While complete wound healing was revealed at the 7th day postoperative in both the non-diabetic and diabetic subgroups treated with PRP after the wound, which was like the non-diabetic control subgroup. Whilst, the diabetic non-treated subgroup only showed partial wound healing at the 7th day postoperative. Conclusion: A single injection of PRP could be used as a prophylactic to prevent expected impaired wound healing in diabetic oral mucosal wounds and to enhance wound healing in non-diabetic wounds. PRP could be used as a therapeutic to enhance wound healing in diabetic and non-diabetic oral mucosal wounds. Key Words: platelet rich plasma, wound healing, diabetes, rat, tongue, p63, vimentin, TEM BACKGROUND: Delayed healing of diabetic wounds has been well-documented. At present, the use of platelet-rich plasma (PRP) has attracted great attention in many medical fields including wound healing. AIM: Histological, immunohistochemical, and ultrastructural evaluation of the effect of PRP on wound healing in the tongue of normal and streptozotocin-induced diabetic albino rats. METHODOLOGY: A total number of 108 adult male albino rats with average weight 200 g were used in the study. The animals were classified into two main groups: Non-diabetic and diabetic groups. Each group was further divided into three subgroups: Non-treated wound, PRP-treatment before wound, and PRP-treatment after wound. Tongue specimens were dissected on post-operative days 1, 3, and 7. The specimens were examined histologically by H&E, immunohistochemically by p63 and vimentin, and ultrastructurally by TEM. RESULTS: The most accelerated wound healing was revealed in the subgroups treated with PRP before the wound, whether non-diabetic or diabetic, which occurred very early at the 3rd day post-operative in both cases. While complete wound healing was revealed at the 7th day post-operative in both the non-diabetic and diabetic subgroups treated with PRP after the wound, which was like the non-diabetic control subgroup. While, the diabetic non-treated subgroup only showed partial wound healing at the 7th day post-operative. CONCLUSION: A single injection of PRP could be used as a prophylactic to prevent expected impaired wound healing in diabetic oral mucosal wounds and to enhance wound healing in non-diabetic wounds. PRP could be used as a therapeutic to enhance wound healing in diabetic and non-diabetic oral mucosal wounds.


2021 ◽  
Vol 22 (4) ◽  
pp. 1538 ◽  
Author(s):  
Pietro Gentile ◽  
Simone Garcovich

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.


2021 ◽  
pp. 1-13
Author(s):  
Eduardo Anitua ◽  
Victoria Muñoz ◽  
Libe Aspe ◽  
Roberto Tierno ◽  
Adrian García-Salvador ◽  
...  

<b><i>Introduction:</i></b> 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. <b><i>Objective:</i></b> 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. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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. <b><i>Conclusion:</i></b> This preliminary study suggests that ES might promote cutaneous wound healing and may be useful for accelerating the re-epithelization of skin ulcers.


2021 ◽  
pp. 088532822199601
Author(s):  
Linying Shi ◽  
Fang Lin ◽  
Mou Zhou ◽  
Yanhui Li ◽  
Wendan Li ◽  
...  

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.


2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Shotaro Isozaki ◽  
Hiroaki Konishi ◽  
Mikihiro Fujiya ◽  
Hiroki Tanaka ◽  
Yuki Murakami ◽  
...  

Inflammatory bowel disease (IBD), such as ulcerative colitis (UC) and Crohn’s disease (CD), is an intractable intestinal inflammation associated with the disruption of the intestinal mucosa. We previously demonstrated that Lactobacillus brevis-derived long-chain polyphosphate (poly P) improved the intestinal barrier function by the upregulation of cell adhesion and relieved intestinal inflammation, thereby exerting a curing effect on colitis in vitro, in vivo, and in an investigator-initiated clinical study of UC. However, how poly P improves mucosal defects induced by intestinal inflammation has not been elucidated. In this study, we detected the accumulation of platelets in inflamed tissues induced by poly P in a dextran sulfate sodium- (DSS-) induced colitis mouse model. A light transmission aggregometry analysis and scanning electron microscopy showed that poly P promoted the platelet aggregation. An SRB assay and ki-67 staining showed that the supernatant of poly P-treated platelet-rich plasma (PRP) increased intestinal epithelial cell growth. A wound healing assay showed that the supernatant of poly P-treated PRP, but not poly P itself, accelerated wound healing. A Western blotting analysis indicated that mitogen-activated protein kinase activation was induced by the supernatant of poly P-treated human PRP in the epithelial cells and its wound healing effect was significantly decreased by the inhibition of ERK signaling. These data suggested that platelet-derived mediators induced by poly P improved intestinal inflammation through the promotion of epithelial cell growth by the activation of the ERK signaling pathway. The mechanism is a novel host-microbe interaction through mammalian platelet-derived mediators induced by bacterial molecules.


Author(s):  
Shobhit Mohan ◽  
Lalit Mohan ◽  
Renu Sangal ◽  
Neelu Singh

<p class="abstract">Platelet rich plasma (PRP) therapies in medicine has become increasing popular during the last decade. The interest in in the application of PRP in dermatology and cosmetology has increased recently in different applications such as alopecia, skin rejuvenation, wound healing, scar revision, and tissue regeneration. PRP is an autologous blood product obtained from the blood of the patients. The detailed knowledge about PRP should help clinicians better understand this therapy. In this view, the current review was done for a better understanding of what pathologies can be corrected with PRP.</p>


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