1. The Use of Autologous Platelet Gel to Treat Difficult-to-Heal Wounds: A Pilot Study
BACKGROUND: Chronic ulcers can benefit from topical treatment with growth factors (GFs). Platelet (PLT) gel provides tissue regeneration-inducing GFs. The aim of this study was to verify the effectiveness of autologous PLT gel in the treatment of nonhealing skin lesions.
STUDY DESIGN AND METHODS: PLT gel was produced by treating PLTs with autologous thrombin. Two groups of patients were investigated: patients with dehiscent sternal wounds and patients with necrotic skin ulcers. Patients treated with PLT gel were retrospectively compared with patients having similar lesions but undergoing conventional treatment. The clinical endpoints of the study were the healing rate, the length of hospital stay, and/or the time required to bring about adequate tissue regeneration in order to undergo reconstructive plastic surgery.
RESULTS: In patients with treated dehiscent sternal wounds the healing rate (3.5 vs. 6.0 wks, p = 0.0002) and hospital stay (31.5 vs. 52.5 days, p < 0.0001) were significantly reduced. Patients with treated necrotic skin ulcers required a notably shorter time to have surgery (median 15.0 vs. 35.5 wks, p < 0.0001). Neither adverse reactions nor in-situ recurrences were observed.
CONCLUSIONS: Patients with chronic unhealing wounds showed substantial improvement when treated with PLT gel lesion dressings.
2. Application of Platelet Gel in Cardiac Surgery: Effects on Sternal Infection
Presented at the Society of Cardiovascular Anesthesiologists Meeting: 9th Annual Update on Cardiopulmonary Bypass, March 2004, Snowmass, CO
Cody C. Trowbridge, Bianca R. Yen, Alfred H. Stammers, James D. Murdock, Myra Klayman, Edward Woods, Christian Gilbert
The use of plasmapheresis in cardiac surgery has failed to show an unequivocal benefit. However, the use of platelet gel may reduce sternal infection rates via poorly understood mechanisms related to a combination of white blood cell content and expedited wound healing. The purpose of the study was to retrospectively evaluate the incidence of sternal wound infections in patients undergoing cardiac surgery. Platelet gel patients (PG) (n=134) received topical administration of a mixture of platelet rich plasma, 10% calcium chloride (5ml), and bovine thrombin (5,000 units)(platelet gel). The control group (CT, n=297) did not receive platelet gel, but otherwise received similar sternal wound care. After Institutional Review Board Approval, twenty factors reported in the literature to predispose individuals for sternal infection were recorded along with overall infection rate. No differences existed in any of the risk factors for sternal infection. The incidence of sternal infection was lower in the PG group than the CT group (1.5% vs 4.1%, p-00.040), despite being similar in the incidence of leg (2.2% vs 2.4%, p=NS), urinary tract (1.5% vs 1.7%, p=NS), and systemic infection (3.0% vs 2.0%, p=NS). The incidence of sternal infection in the group receiving topical platelet gel was lower than the control group, despite being at equivalent risk and experiencing similar rates of other infections.
3. Autologous Platelet Gel Applications During Cardiovascular Surgery: Effects on Wound Healing
Journal of Extra-Corporeal Technology: 2005;37:148-152
Study Design: This pilot study was a prospective randomized study that evaluated the effects of autologous platelet gel on postoperative sternal wound healing, evidenced by subjective reports of pain and the amount of measurable bruising incurred. Subjects were instructed how to rate their pain by the principle investigator, with “0” representing no pain and “10” representing the worst possible pain.
|Chest and leg pain means and standard deviation between groups on|
|post-operative days 1, 3, and the office visit (OV)|
|Control Group||Platelet Gel Group|
|Variable||(n = 15)||(n = 15)|
|(pain scale 0-10)||Mean (SD)||Mean (SD)|
|Chest pain day 1||4.47 (2.06)||1.47 (0.83)|
|Chest pain day 3||4.53 (2.33)||1.40 (0.75)|
|Chest pain office visit||2.27 (1.33)||0.53 (0.64)|
|Leg pain day 1||3.06 (1.62)||1.33 (0.72)|
|Leg pain day 3||2.80 (2.27)||1.46 (0.74)|
|Leg pain office visit||2.33 (1.72)||0.53 (0.64)|
Bruising evaluation: The platelet gel group was observed to have less bruising, although due to small sample size and amount of variance the result could not be statistically substantiated.