Platelet-derived Concentrates Influence Human Keratinocyte Proliferation and Induce Wound Healing in a Prospective Case Series of Chronic Wounds of Different Entities

Overview

Journal Innov Surg Sci

Publisher De Gruyter

Specialty General Surgery

Date 2022 Nov 1

PMID 36317012

Authors

Anastasia Paulmann

Sarah Strauss

Anne Limbourg

Peter M Vogt

Affiliations

Soon will be listed here.

Abstract

Objectives: Soft tissues defects can extend into the fat layer or even deeper and can cause significant clinical disadvantages like pain, infections, and loss of function. In particular, chronic wounds are difficult to treat, as split-thickness skin grafts (STSGs) have varying success rates. To improve wound healing in chronic wounds, the authors have studied the application of platelet-mediator concentrate (PMC) in a human keratinocyte culture model and of autologous platelet concentrates (PRP) in a combination with surgical procedures as second line therapy in patients with initially failed wound closure.

Methods: For testing on keratinocytes, a PMC was processed with a commercially available bedside system (ATR, Curasan, Germany). In a clinical, nonrandomized study, five in-house patients with chronic wounds were treated using a combination of surgical debridement and autologous PRP. Time of healing as determined by epithelization as well as laser Doppler imaging to visualize blood flow was analyzed. Additionally, changes in ease of surgical wound closure were determined. Finally, the quality of life of patients was assessed using a validated questionnaire (clinicaltrials.gov # NCT03667638).

Results: testing shows a significant effect of PMC on keratinocyte proliferation in cell culture. Clinical studies showed that patients treated with PRP had initiation of wound closure, higher blood flow after PRP injection, and easier wound closure as well as improved quality of life.

Conclusions: The injection of platelet concentrates to treat chronic wound defects presents a favorable addition to treatment where single surgical procedures have failed and may improve current therapy options.

Citing Articles

PRF Lysates Enhance the Proliferation and Migration of Oral Squamous Carcinoma Cell Lines.

Panahipour L, Croci R, Guarnieri S, Gruber R Dent J (Basel). 2023; 11(10).

PMID: 37886927 PMC: 10605502. DOI: 10.3390/dj11100242.

References

Xian L, Chowdhury S, Saim A, Idrus R . Concentration-dependent effect of platelet-rich plasma on keratinocyte and fibroblast wound healing. Cytotherapy. 2014; 17(3):293-300. DOI: 10.1016/j.jcyt.2014.10.005. View

Mazzucco L, Borzini P, Gope R . Platelet-derived factors involved in tissue repair-from signal to function. Transfus Med Rev. 2010; 24(3):218-34. DOI: 10.1016/j.tmrv.2010.03.004. View

Kim S, Ryu H, Lee K, Cho J . Application of platelet-rich plasma accelerates the wound healing process in acute and chronic ulcers through rapid migration and upregulation of cyclin A and CDK4 in HaCaT cells. Mol Med Rep. 2012; 7(2):476-80. DOI: 10.3892/mmr.2012.1230. View

House S . Psychological distress and its impact on wound healing: an integrative review. J Wound Ostomy Continence Nurs. 2014; 42(1):38-41. DOI: 10.1097/WON.0000000000000080. View

Barrientos S, Stojadinovic O, Golinko M, Brem H, Tomic-Canic M . Growth factors and cytokines in wound healing. Wound Repair Regen. 2009; 16(5):585-601. DOI: 10.1111/j.1524-475X.2008.00410.x. View

Gilliver S, Ashworth J, Ashcroft G . The hormonal regulation of cutaneous wound healing. Clin Dermatol. 2007; 25(1):56-62. DOI: 10.1016/j.clindermatol.2006.09.012. View

Nurden A, Nurden P, Sanchez M, Andia I, Anitua E . Platelets and wound healing. Front Biosci. 2008; 13:3532-48. DOI: 10.2741/2947. View

Kaltalioglu K, Coskun-Cevher S . A bioactive molecule in a complex wound healing process: platelet-derived growth factor. Int J Dermatol. 2014; 54(8):972-7. DOI: 10.1111/ijd.12731. View

Danielsen P, Jorgensen B, Karlsmark T, Jorgensen L, Agren M . Effect of topical autologous platelet-rich fibrin versus no intervention on epithelialization of donor sites and meshed split-thickness skin autografts: a randomized clinical trial. Plast Reconstr Surg. 2008; 122(5):1431-1440. DOI: 10.1097/PRS.0b013e318188202c. View

10.

Anitua E, Aguirre J, Algorta J, Ayerdi E, Cabezas A, Orive G . Effectiveness of autologous preparation rich in growth factors for the treatment of chronic cutaneous ulcers. J Biomed Mater Res B Appl Biomater. 2007; 84(2):415-21. DOI: 10.1002/jbm.b.30886. View

11.

ROBSON M, Maggi S, Smith P, Wassermann R, Mosiello G, Hill D . Original articles: ease of wound closure as an endpoint of treatment efficacy. Wound Repair Regen. 1999; 7(2):90-6. DOI: 10.1046/j.1524-475x.1999.00090.x. View

12.

Alsousou J, Thompson M, Hulley P, Noble A, Willett K . The biology of platelet-rich plasma and its application in trauma and orthopaedic surgery: a review of the literature. J Bone Joint Surg Br. 2009; 91(8):987-96. DOI: 10.1302/0301-620X.91B8.22546. View

13.

Amable P, Carias R, Teixeira M, da Cruz Pacheco I, Farias Correa do Amaral R, Granjeiro J . Platelet-rich plasma preparation for regenerative medicine: optimization and quantification of cytokines and growth factors. Stem Cell Res Ther. 2013; 4(3):67. PMC: 3706762. DOI: 10.1186/scrt218. View

14.

Cho J, Kim S, Lee K . Platelet-rich plasma induces increased expression of G1 cell cycle regulators, type I collagen, and matrix metalloproteinase-1 in human skin fibroblasts. Int J Mol Med. 2011; 29(1):32-6. DOI: 10.3892/ijmm.2011.803. View

15.

Okuda K, Kawase T, Momose M, Murata M, Saito Y, Suzuki H . Platelet-rich plasma contains high levels of platelet-derived growth factor and transforming growth factor-beta and modulates the proliferation of periodontally related cells in vitro. J Periodontol. 2003; 74(6):849-57. DOI: 10.1902/jop.2003.74.6.849. View

16.

Reinke J, Sorg H . Wound repair and regeneration. Eur Surg Res. 2012; 49(1):35-43. DOI: 10.1159/000339613. View

17.

Asadi M, Alamdari D, Rahimi H, Aliakbarian M, Jangjoo A, Abdollahi A . Treatment of life-threatening wounds with a combination of allogenic platelet-rich plasma, fibrin glue and collagen matrix, and a literature review. Exp Ther Med. 2014; 8(2):423-429. PMC: 4079439. DOI: 10.3892/etm.2014.1747. View

18.

Limbourg A, Korff T, Napp L, Schaper W, Drexler H, Limbourg F . Evaluation of postnatal arteriogenesis and angiogenesis in a mouse model of hind-limb ischemia. Nat Protoc. 2009; 4(12):1737-46. DOI: 10.1038/nprot.2009.185. View

19.

Mammoto T, Jiang A, Jiang E, Mammoto A . Platelet rich plasma extract promotes angiogenesis through the angiopoietin1-Tie2 pathway. Microvasc Res. 2013; 89:15-24. DOI: 10.1016/j.mvr.2013.04.008. View

20.

Appel T, Potzsch B, Muller J, von Lindern J, Berge S, Reich R . Comparison of three different preparations of platelet concentrates for growth factor enrichment. Clin Oral Implants Res. 2002; 13(5):522-8. DOI: 10.1034/j.1600-0501.2002.130512.x. View