Abstract
Introduction. Platelets play a central role in haemostasis and wound healing. We have used autologous Platelet Rich Plasma (PRP) to stimulate healing in a variety of cases. We would like to present our early experience with this technique.
Method. PRP is produced by centrifuging a sample of the patient’s blood. The volume of PRP produced is about 10% of the original volume. Thrombin, derived from the patient’s plasma, is mixed with the PRP to produce a platelet gel. This gel is semi-solid and makes the PRP more manageable intra-operatively. It can be used on its own, mixed with bone graft or de-mineralised bone matrix (DBM.)
Results. We have used platelet gel in 14 cases for a variety of clinical conditions. 57% were males and the mean age was 44.1 (range: 7–77.) Cases included 3 elective joint fusions, 7 non unions, 2 case of chronic osteomyelitis, 1 acute fracture and 1 pathological fracture. The gel was mixed with autologous bone graft in 10 cases, DBM in 1 case and used on its own in 3 cases. The number of cases is too small to make any comment on the rate of bone union. Some practical issues have arisen during the use of platelet gel.
Discussion. Is it better to give a large number of growth factors at slightly above background levels or a single growth factor millions of times above background level? This paper doesn’t answer that question but because wound and bone healing relies upon a cascade of growth factors, it is attractive to be able to provide many of these factors. Further studies are required to answer this fundamental question.
Correspondence should be addressed to: S. Dhar, BLRS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
