A new simplified technique for producing platelet-rich plasma: a short technical note

Abstract

A possible strategy to promote the wound-healing cascade in both soft and hard tissues is the preparation of an autologous platelet-rich plasma (PRP) to encourage the release of growth factors from activated platelets. In this process, PRP combines the advantage of an autologous fibrin clot that will aid in hemostasis as well as provide growth factors in high concentrations to the site of a tissue defect. The PRP preparation can be used as a biological enhancer in the healing of fractures and lumbar fusions. The local application of growth factors seems to promote initiation and early maturation of bone formation. Autologous bone or bone substitutes can be added to this mixture to increase the volume of grafting material. A simplified technique utilizing a commercially available separation system (GPS-Gravitational Platelet Separation System) is described. This system provides a less costly alternative to other previously described augmentation techniques and also presents a patient-friendly and operator-safe alternative. Further experimental studies of the actual concentrations of the growth factors in the PRP samples are necessary in order to validate the platelet concentration and growth-factor activation by laboratory evidence. In further prospective clinical trials, the safety and efficacy of PRP, in combination with autologous bone or bone graft substitutes, must be evaluated.

Fig. 1A, B

Schematic view of the disposable GPS tube after centrifugation at 3,200 rpm for 12 min. The red blood cell fraction on the bottom of the tube is separated through a buoy from the buffy coat and the platelet-poor from the platelet-rich plasma (A). A plunger is manually pushed down and separates the platelet-poor from the platelet-rich plasma (B)

Fig. 2A-C

The GPS tube after centrifugation with the red-colored fraction of red blood cells on the bottom and the buffy coat above the buoy (A). The tube after the separation of the PRP, with a manually pushed down plunger (B) and the extraction of the PRP (C)

Fig. 3A-D

PRP and autologous thrombin solution on the operation table (A), aspirated in a double syringe in a 10:1 ratio (B), forming a clot after combination (C) and mixed with autologous bone (D)

Fig. 4A-D

Example of a 62-year-old man who presented with a burst fracture of L2, with extensive loss of height in the vertebral body (A, ap view; and B, lateral view). The operation consisted of a retroperitoneal approach, partial resection of the fractured vertebral body, reduction by a distractable cage, and stabilization with a plate system. Autogenous bone was mixed with PRP (C, intraoperative site; and D, postoperative ap X-ray)