Top

Published in:

Open Access 01-11-2007

The use of autologous platelet–leukocyte gels to enhance the healing process in surgery, a review

Authors: P. A. Everts, E. P. Overdevest, J. J. Jakimowicz, C. J. Oosterbos, J. P. Schönberger, J. T. Knape, A. van Zundert

Published in: Surgical Endoscopy | Issue 11/2007

Abstract

Background

The therapeutic use of autologously prepared, platelet–leukocyte-enriched gel (PLG) is a relatively new technology for the stimulation and acceleration of soft tissue and bone healing. The effectiveness of this procedure lies in the delivery of a wide range of platelet growth factors mimicking the physiologic wound healing and reparative tissue processes. Despite an increase in PLG applications, the structures and kinetics of this autogenously derived biologic material have not been observed.

Methods

A review of the most recent literature was performed to evaluate the use of PLG in various surgical disciplines.

Results

The review showed that the application of PLG has been extended to various surgical disciplines including orthopedics, cardiac surgery, plastic and maxillofacial surgery, and recently also endoscopic surgery.

Conclusion

This review demonstrates the usefulness of PLG in a wide range of clinical applications for improvement of healing after surgical procedures.

Hunt TK (1990) Basic principles of wound healing. J Trauma 30(Suppl): 122–128

Giannoble WV (1996) Periodontal tissue engineering by growth factors. Bone 19(Suppl): 23–37CrossRef

Landesberger R, Moses M, Karpatkin M (1998) Risks of using platelet rich plasma. J Oral Maxillofac Surg 56: 1116–1117CrossRef

Weibrich G, Kleis WKG, Hafner G (2002) Growth factor levels in the platelet-rich plasma produced by 2 different methods: curasan-type PRP kit versus PCCS PRP system. Int J Oral Maxillofac Imp 17: 184–190

Zucker-Franklin C (1989) The relationship of alpha granules to the membrane system of platelets and megakaryocytes. Blood Cells 15: 73–79PubMed

Slater M, Patava J, Kingham K, Mason RS (1995) Involvement of platelets in stimulating osteogenic activity. J Orthop Res 13: 655–663PubMedCrossRef

Tabata Y (2003) Tissue regeneration based on growth factor release. Tissue Eng 9(Suppl): 5–15CrossRef

Kevy SV, Jacobson MS (2004) Comparison of methods for point of care preparation of autologous platelet gel. J Extra Corpor Technol 36: 28–35PubMed

Everts PAM, Brown Mahoney Ch, Hoffmann JJHL, Schönberger JPAM, Box HAM, van Zundert A, Knape JTA (2006) Platelet-rich plasma preparation using three devices: implications on platelet activation and platelet growth factor release. Growth Factors 24: 164–171CrossRef

10.

Fréchette J-P, Martineau I, Gagnon G (2005) Platelet-rich plasmas: Growth factor content and roles in wound healing. J Dent Res 84: 434–439PubMedCrossRef

11.

Everts PAM, Hoffmann JJHL, Weibrich G, Brown Mahoney Chr, Schönberger JPAM, van Zundert A, Knape JTA (2006) Autologous platelet gel growth factor release and leukocyte kinetics using three devices. Transfus Med 16: 363–368PubMedCrossRef

12.

Werner S, Grose R (2003) Regulation of wound healing by growth factors and cytokines. Physiol Rev 83: 835–870PubMed

13.

Lieberman JR, Daluiski A, Einhorn TA (2002) The role of growth factors in the repair of bone. J Bone Joint Surg Am 84: 1032–1044PubMed

14.

Robson MC (1991) Growth factors as wound healing agents. Curr Opion Biotechnol 2: 863–867CrossRef

15.

Luginbuehl V, Meinel L, Merkle HP, Gander B (2004) Localized delivery of growth factors for bone repair. Eur J Pharm Biopharm 58: 197–208PubMedCrossRef

16.

Lynch SE, Nixon JC, Colvin RB, Antoniades HN (1987) Role of platelet-derived growth factor in wound healing: synergistic effects with other growth factors. Proc Natl Acad Sci U S A 84: 7696–7700PubMedCrossRef

17.

Brown RL, Breeden MP, Greenhalg DG (1994) PDGF and TGF-alpha act synergistically to improve wound healing in the genetically diabetic mouse. J Surg Res 56: 562–570PubMedCrossRef

18.

Man D, Plosker H, Winland-Brown JE (2001) The use of autologous platelet-rich plasma [platelet gel] and autologous platelet-poor plasma [fibrin glue] in cosmetic surgery. Plast Reconstr Surg 107: 229–237PubMedCrossRef

19.

Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgeff KR (1998) Platelet-rich-plasma: growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85: 638–646PubMedCrossRef

20.

Sanchez AR, Sheridan PJ, Kupp LI (2003) Is platelet-rich plasma the perfect enhancement factor? A current review. Int J Oral Maxillofac Surg 18: 93–103

21.

Trowbridge CC, Stammers AH, Woods E, Yen BR, Klayman M (2005) Use of platelet gel and its effects on infection in cardiac surgery. J Extra Corpor Technol 37: 381–386PubMed

22.

Margolis DJ, Kantor J, Santanna J, Strom BL, Berlin JA (2001) Effectiveness of platelet releasate for the treatment of diabetic neuropathic foot ulcers. Diabetes Care 24: 483–488PubMedCrossRef

23.

Everts PAM, Devilee RJJ, Brown-Mahoney Chr, Eeftinck Schattenkerk M, Box HAM, Knape JTA, van Zundert A (2006) Platelet gel and fibrin sealant reduce allogenic blood transfusions and in total knee arthroplasty. Acta Anaesth Scand 50: 593–599PubMedCrossRef

24.

Kannus P, Natri A (1997) Etiology and pathophysiology of tendon ruptures in sports. Scan J Med Sci Sports 7: 107–112CrossRef

25.

Sharma P, Mafulli N (2005) Tendon injury and tendinopathy: healing and repair. J Bone Joint Surg Am 87: 187–202PubMedCrossRef

26.

Aspenberg P, Virchenko O (2004) Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand 75: 93–99PubMedCrossRef

27.

Sanchez M, Anitua E, Andia I (2003) Use of autologous plasma-rich in growth factors in arthroscopic surgery. Cuader Artroscopia 10: 12–19

28.

Anitua E (2006) Reciprocal actions of platelet-secreted TGF-b1 on the production of VEGF and HGF by human tendon cells. Plast. Reconstr Surg (in press)

29.

Awad HA, Boivin GP, Dressier MR, Smith FN, Young RG, Butler DL (2003) Repair of patellar tendon injuries using a cell–collagen composite. J Orthop Res 21: 420–431PubMedCrossRef

30.

Detweiler MB, Detweiler JG, Fenton J (1999) Sutureless and reduced suture anastomosis of hollow vessels with fibrin glue: a review. J Invest Surg 12: 245–262PubMedCrossRef

31.

Bonanomi G, Prince JM, McSteen F, Schauer PR, Hamad GG (2004) Sealing effect of fibrin glue on the healing of gastrointestinal anastomoses: implications for the endoscopic treatment of leaks. Surg Endosc 18: 1620–1624PubMed

32.

Brady C, Vang S, Christensen K, Isler J, Vollstedt K, Holt D (2006) Use of platelet gel in bariatric surgery. J Extracorp Technol 38: 161–164

33.

Pomerantz J, Dutton JM (2005) Platelet gel for endoscopic sinus surgery. Ann Otol Rhinol Laryngol 114: 699–704PubMed

34.

Amid P, Shulman A, Lichtenstein I (1994) A critical evaluation of the Lichtenstein tension-free hernioplasty. Int Surg 79: 76–79PubMed

35.

Tyrell J, Silberman H, Chandrasoma P, Niland J, Shull J (1989) Absorbable versus permanent mesh in abdominal operations. Surg Gynecol Obstet 168: 227–232PubMed

36.

Coderre TJ, Katz J, Vaccarino Al, MelzacK R (1993) Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence. Pain 52: 259–285PubMedCrossRef

37.

Kawit R, Feichter A, Fuchsjager N, Kux M (1999) Postoperative pain and return to activity after five different types of inguinal herniorrhaphy. Hernia 3: 31–35CrossRef

38.

Canonico S, Santoriello A, Campitiello F, Fattopace A, Corte AD, Sordelli I, Benevento R (1999) Mesh fixation with human fibrin glue (Tissucol) in open tension-free inguinal hernia repair: a preliminary report. Hernia 9: 330–333CrossRef

39.

Zieren J, Castenholz E, Baumgart E, Muller JM (1999) Effects of fibrin glue and growth factors released from platelets on abdominal hernia repair with a resorbable PGA mesh: experimental study. J Surg Res 85: 267–272PubMedCrossRef

40.

Sclafani AP, Romo T , Ukrainsky G, McCormick SA, Litner J, Kevy SV, Jacobson MS (2005) Modulation of wound response and soft tissue ingrowth in synthetic and allogeneic implants with platelet concentrate. Arch Facial Plast Surg 7: 163–169PubMedCrossRef

41.

Bolander ME (1992) Regulation of fracture repair by growth factors. Proc Soc Exp Biol Med 200: 165–170PubMed

42.

Thiede MA, Smock SL, Petersen DN, Grasser WA, Nishimoto SK, Thompson DD (1993) Production of osteocalcin by platelets: a potentially important link of platelet action in bone turnover. J Bone Miner Res 8(Suppl): 147–151

43.

Gruber R, Karreth F, Fischer MB, Watzek G (2002) Platelet-released supernatants stimulate formation of osteoclast-like cells through a prostaglandin/RANKLdependent mechanism. Bone 30: 726–732PubMedCrossRef

44.

Aghaloo T, Moy P, Freymiller E (2004) Evaluation of platelet-rich plasma in combination with an organic bovine bone in the rabbit cranium: a pilot study. Int J Oral Maxillofac Implants 19: 59–65PubMed

45.

Suba Z, Takacs D, Gyulai-Gaal S, Kovacs K (2004). Facilitation of b-tricalcium phosphate-induced alveolar bone regeneration by platelet-rich plasma in beagle dogs: a histologic and histomorphometric study. Int J Oral Maxillofac Implants 19: 832–838PubMed

46.

Gandhi A, Doumas C, O’Connor JP, Parsons J, Lin S (2006) The effects of local platelet rich plasma delivery on diabetic fracture healing. Bone 38: 540–546PubMedCrossRef

47.

Yamada Y, Ueda M, Hibi H, Nagasaka T (2004) Translational research for injectable tissue engineered bone regeneration using mesenchymal stem cells and platelet-rich plasma: from basic research to clinical case study. Cell Transplant 13: 343–355PubMed

48.

Langer R, Vacanti J (1993) Tissue engineering. Science 260: 920–926PubMedCrossRef

49.

Lucarelli E, Beccheroni A, Donati D, Sangiorgi L, Cenacchi A, Del Vento AM, Giardino R, Fornasari PM, Mercuri M, Picci P (2003) Platelet-derived growth factors enhance proliferation of human stromal stem cells. Biomaterials 24: 3095–3100PubMedCrossRef

50.

Zhu SJ, Choi BH, Jung JH, Lee SH, Huh JY, You TM, Lee HJ, Li J (2006) A comparative histologic analysis of tissue-engineered bone using platelet-rich plasma and platelet-enriched fibrin glue. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102: 175–179PubMedCrossRef

51.

Anitua E, Sanchez M, Nurden A, Nurden P, Orive G, Andia I (2006) New insights into and novel applications for platelet-rich fibrin therapies. Trend Biotechnol 24: 227–234CrossRef

52.

Yamada Y, Ueda M, Naiki T, Takahashi M, Hata K, Nagasaka T (2004) Autogenous injectable bone for regeneration with mesenchymal stem cells and platelet-rich plasma: tissue-engineered bone regeneration. Tissue Eng 10: 955–964PubMedCrossRef

53.

Kitoh H, Kitakoji T, Tsuchiya H (2004) Transplantation of marrow-derived mesenchymal stem cells and platelet-rich plasma during distraction osteogenesis: a preliminary result of three cases. Bone 35: 892–898PubMedCrossRef

54.

Anitua E, Andia I, Sanchez M, Azofra J, del Mar Zalduendo M, de la Fuente M, Nurden P, Nurden AT (2004) Autologous preparations rich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture. J Orthop Res 23: 281–286CrossRef

55.

Hazen SL, d’Avignon A, Anderson MM, Hsu FF, Heinecke JW (1998) Human neutrophils employ the myeloperoxidase–hydrogen peroxide–chloride system to oxidize α-amino acids to a family of reactive aldehydes. J Biol Chem 273: 4997–5005PubMedCrossRef

56.

Lincoln JA, Lefkowitz DL, Cain T, Castro A, Mills KC, Lefkowitz SS, Moguilevsky N, Bollen A (1995) Exogenous myeloperoxidase enhances bacterial phagocytosis and intracellular killing by macrophages. Infect Immun 63: 3042–3047PubMed

57.

Yeaman MR, Bayer AS, Koo S-P, Foss W, Sullam PM (1998) Platelet microbicidal proteins and neutrophil defensin disrupt the Staphylococcus aureus cytoplasmic membrane by distinct mechanisms of action. J Clin Invest 101: 178–187PubMedCrossRef

58.

Tang Y-Q, Yeaman MR, Selsted ME (2002) Antimicrobial peptides from human platelets. Infect Immun 70: 6524–6533PubMedCrossRef

59.

Krijgsveld J, Zaat SA, Meeldijk J, van Veelen PA, Fang G, Poolman B, Brandt E, Ehlert JE, Kuijpers AJ, Engbers GH, Feijen J, Dankert J (2000) Thrombocidins, microbicidal proteins from human blood platelets, are c-terminal deletion products of CXC chemokines. J Biol Chem 275: 20374–20381PubMedCrossRef

60.

Donnelly BP, Nixon AJ, Haupt JL, Dahlgren LA (2006) Nucleotide structure of equine platelet-derived growth factor-A and -B and expression in horses with induced acute tendonitis. Am J Vet Res 67: 1218–1225PubMedCrossRef

Title: The use of autologous platelet–leukocyte gels to enhance the healing process in surgery, a review
Authors: P. A. Everts
E. P. Overdevest
J. J. Jakimowicz
C. J. Oosterbos
J. P. Schönberger
J. T. Knape
A. van Zundert
Publication date: 01-11-2007
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 11/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-007-9293-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The use of autologous platelet–leukocyte gels to enhance the healing process in surgery, a review

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 11/2007

Reoperative bariatric surgery

Laparoscopic bariatric surgery: what else are we uncovering? Liver pathology and preoperative indicators of advanced liver disease in morbidly obese patients

Influence of instrument size on endoscopic task performance in pediatric intracorporeal knot tying

The influence of experience and camera holding on laparoscopic instrument movements measured with the TrEndo tracking system

Thoracoscopic tracheoaortopexia for the treatment of life-threatening events in tracheomalacia

Reoperation for marginal ulceration