Platelet Rich Plasma

PLATELET RICH PLASMA (PRP) INJECTIONS

PRP (Platelet Rich Plasma) - also called autologous platelet gel, platelet concentrate (PC) or plasma rich in growth factor (PRGF) - is blood plasma which has a high concentration of platelets (blood component responsible for clotting).

Blood contains around 93% of red blood cells or RBCs, 1% of white blood cells and 6% of platelets, all of which are suspended in plasma. In Platelet Rich Plasma, the RBC percentage is around 5%, and the platelet concentration increases to 94% approximately.

PRP is autologous, which means it is obtained from the patient. Hence, it is free from the risk of mismatch transfusion and transmission of blood-borne infections like HIV.

These platelets in the PRP are a rich source of chemicals called growth factors and cytokines, which play a pivotal role in tissue healing. Owing to this property, PRP has been successfully used in various medical disciplines like Dermatology, Orthopedics, and Dentistry.

How is Platelet Rich Plasma Prepared?

Blood collected from the patient is treated with an anticoagulant to prevent the blood from clotting. This sample is then subjected to two rounds of centrifugation (the blood is put in a machine that spins it at high speed, and this helps separate the various blood components). The platelet count in the plasma after centrifugation is roughly five times the normal platelet count.

What does Platelet Rich Plasma Treat?

Vascular endothelial growth factor
Platelet-derived growth factor
Transforming growth factor-beta
Insulin-like growth factor 1
Insulin-like growth factor 2
Fibroblast growth factor
Epidermal growth factor
Interleukin 8
Keratinocyte growth factor
Connective tissue growth factor

Clinical Information on Platelet Rich Plasma

Platelet Rich Plasma was developed in 1970 and was first used in Italy in an open heart surgery in 1987. However, PRP started gaining popularity in the mid-90s, and its efficacy has been proven in various clinical scenarios like:

Nerve injury
Chronic osteoarthritis
Tendinitis
Plantar fasciitis
Pressure ulcers (bedsores).
Diabetic foot ulcers
Venous and arterial leg ulcers.
First and second-degree burns.
Surgical wounds
Skin graft donor sites.
Superficial injuries, cuts, and abrasions.
Hair loss disorders, e.g. androgenic alopecia, where it helps stimulate dormant hair follicles and promote new hair growth.
Facial rejuvenation – PRP helps in wrinkle treatment and sunburns.
Post-traumatic scars – in combination with centrifuged fat tissue and fractional laser resurfacing, Platelet-Rich Plasma helps to improve the cosmetic appearance of scars.

Aesthetic and Orthopedic Use of PRP

Autologous PRP is used in the rejuvenation of skin, both epithelium and mesenchyme. It is one of the significant treatments in cosmetic anti-aging procedures.

PRP is used in the treatment of many bone conditions. Quite interestingly, many miscellaneous conditions are treated by PRP. Dupytren contracture, epicondylitis, Plantar fasciitis etc are treated by PRP injections.

PRP Complications & Contraindications

Since Platelet Rich Plasma is derived from the patient’s body (autologous), hence, the chances of an immune reaction or hypersensitivity are almost nil:

Commonly, patients might encounter pain and swelling at the site where the PRP is injected.
Accidental injection into a nerve can cause nerve injury.
Infection at the injection site if proper sterile precaution not ensured during the procedure.

PRP is Contraindicated in the Following Clinical Scenarios:

Thrombocytopenia (low platelet count).
Hemodynamic instability (collapse).
Septicemia
Acute and chronic infections.
Chronic liver disease
Patient on anticoagulant therapy like Warfarin.

Successful PRP Procedures:

When PRP is administered via superficial or deep dermalinjection, skin tone, firmness and texture have improved within three weeks, and improvement has continued for several months.
Common sites of PRP injection for cosmetic enhancement are cheeks, around the eyes, jawline, neck, back of the hands, elbows, upper arms and post-pregnancy stretch marks.
Treatment of chronic diabetic ulcer using a mix of PRP, autologous fat and a mesh of hyaluronic acid.

It is always good to remember to talk to your doctor before seeking PRP therapy. Since this therapy requires a certain degree of expertise, approaching a qualified healthcare provider is ideal.