Is the manual preparation of platelet rich plasma safe?
DOI:
https://doi.org/10.33448/rsd-v11i10.32270Keywords:
Platelet-rich plasma ; Sample preparation; Biological safety; Biological contamination; Practice Patterns.Abstract
The safety and sterility of Platelet Rich Plasma (PRP) produced manually concerns the scientific community, since there is a huge gap in the literature on the subject. Understanding the risks inherent to sterile handling and incorporating standard procedures is essential for patient safety, with an increasing demand for safely and effectively producing PRP without the prohibitive costs of commercial kits. The purpose of our research project is to show that through adequate training and qualification of health professionals, we can produce a low-cost, extremely safe, and effective product that fits perfectly into the reality of underdeveloped and emerging countries. We have developed a detailed step-by-step guide for standardizing the procedure for manual preparation of PRP, which ranges from the venipuncture procedure, including equipment cleaning, to the preparation of the PRP. Twenty-two PRP samples were produced and sent to an independent analysis laboratory, for identification and isolation of microorganisms through culture media. No microorganisms were identified and isolated from the samples, resulting in a contamination percentage of 0%, proving the effectiveness of the training and method in producing PRP in a safe and sterile way. Through the training of health professionals and the suggested protocols, it was possible to confirm our hypothesis that it is feasible to manually prepare contaminant-free PRP, which is safe for use in interventions where the product is recommended, without the need of commercial kits.
References
Berghoff, W. J., Pietrzak, W. S., & Rhodes, R. D. (2006). Platelet-rich plasma application during closure following total knee arthroplasty. Orthopedics, 29(7), 590–598.
Castillo, T. N., Pouliot, M. A., Kim, H. J., & Dragoo, J. L. (2011). Comparison of growth factor and platelet concentration from commercial platelet-rich plasma separation systems. The American journal of sports medicine, 39(2), 266–271.
Creaney, L., & Hamilton, B. (2008). Growth factor delivery methods in the management of sports injuries: the state of play. British journal of sports medicine, 42(5), 314–320.
De Castro R. L. B., Antonio B. P., de Castro M. F. C., & de Castro G. C. (2020). Clinical improvement and signs of healing in the treatment of partial rupture of supraspinatus tendon using platelet rich plasma: A prospective study. Sports medicine and rehabilitation journal, 5(1): 1051.
De Castro R. L. B., Antonio B. P., de Castro M. F. C., & de Castro G. C. (2020). Is the association of platelet rich plasma and hyaluronic acid useful for severe knee arthrosis?. Fortune journal of rheumatology. 090-106.
De Carli, A., Volpi, P., Pelosini, I., Ferretti, A., Melegati, G., Mossa, L., Tornese, D., de Girolamo, L., & Scarpignato, C. (2009). New therapeutic approaches for management of sport-induced muscle strains. Advances in therapy, 26(12), 1072–1083.
Di Martino, A., Boffa, A., Andriolo, L., Romandini, I., Altamura, S. A., Cenacchi, A., Roverini, V., Zaffagnini, S., & Filardo, G. (2022). Leukocyte-Rich versus Leukocyte-Poor Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Trial. The American journal of sports medicine, 50(3), 609–617.
Gandhi, A., Doumas, C., O'Connor, J. P., Parsons, J. R., & Lin, S. S. (2006). The effects of local platelet rich plasma delivery on diabetic fracture healing. Bone, 38(4), 540–546.
Grageda E. (2004). Platelet-rich plasma and bone graft materials: a review and a standardized research protocol. Implant dentistry, 13(4), 301–309.
Gupta, V., Parihar, A. S., Pathak, M., & Sharma, V. K. (2020). Comparison of Platelet-Rich Plasma Prepared Using Two Methods: Manual Double Spin Method versus a Commercially Available Automated Device. Indian dermatology online journal, 11(4), 575–579.
Hall, M. P., Band, P. A., Meislin, R. J., Jazrawi, L. M., & Cardone, D. A. (2009). Platelet-rich plasma: current concepts and application in sports medicine. The Journal of the American Academy of Orthopaedic Surgeons, 17(10), 602–608.
Hammond, J. W., Hinton, R. Y., Curl, L. A., Muriel, J. M., & Lovering, R. M. (2009). Use of autologous platelet-rich plasma to treat muscle strain injuries. The American journal of sports medicine, 37(6), 1135–1142.
Harrison, T. E., Bowler, J., Levins, T. N., Cheng, A. L., & Reeves, K. D. (2020). Platelet yield and yield consistency for six single-spin methods of platelet rich plasma preparation. Platelets, 31(5), 661–666.
Hart, R., Safi, A., Komzák, M., Jajtner, P., Puskeiler, M., & Hartová, P. (2013). Platelet-rich plasma in patients with tibiofemoral cartilage degeneration. Archives of orthopaedic and trauma surgery, 133(9), 1295–1301.
Instituto Brasileiro de Geografia e Estatística. (2021). Estimativas da população residente no Brasil e unidades da federação com data de referência em 1º de julho de 2021. Rio de Janeiro: IBGE.
Jo, C. H., Roh, Y. H., Kim, J. E., Shin, S., & Yoon, K. S. (2013). Optimizing platelet-rich plasma gel formation by varying time and gravitational forces during centrifugation. The Journal of oral implantology, 39(5), 525–532.
Kemmochi M. (2022). Consecutive injections of leukocyte-rich platelet-rich plasma are effective in not only mild but also severe knee degeneration. Journal of orthopaedics, 29, 31–37.
Krief, S., Berrebi-Bertrand, I., Nagmar, I., Giret, M., Belliard, S., Perrin, D., Uguen, M., Robert, P., Lecomte, J. M., Schwartz, J. C., Finance, O., & Ligneau, X. (2021). Pitolisant, a wake-promoting agent devoid of psychostimulant properties: Preclinical comparison with amphetamine, modafinil, and solriamfetol. Pharmacology research & perspectives, 9(5), e00855.
Marlovits, S., Mousavi, M., Gäbler, C., Erdös, J., & Vécsei, V. (2004). A new simplified technique for producing platelet-rich plasma: a short technical note. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 13 Suppl 1(Suppl 1), S102–S106.
Menetrey, J., Kasemkijwattana, C., Day, C. S., Bosch, P., Vogt, M., Fu, F. H., Moreland, M. S., & Huard, J. (2000). Growth factors improve muscle healing in vivo. The Journal of bone and joint surgery. British volume, 82(1), 131–137.
Peterson, N.S., & Reeves, K.D. (2014). Efficacy of one day training in low-cost manual preparation of high cellular platelet rich plasma. Journal of prolotherapy, 6:e922-e927.
Oh, J. H., Kim, W., Park, K. U., & Roh, Y. H. (2015). Comparison of the Cellular Composition and Cytokine-Release Kinetics of Various Platelet-Rich Plasma Preparations. The American journal of sports medicine, 43(12), 3062–3070.
Sánchez, M., Anitua, E., Azofra, J., Andía, I., Padilla, S., & Mujika, I. (2007). Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. The American journal of sports medicine, 35(2), 245–251.
Sanchez, M., Anitua, E., Cugat, R., Azofra, J., Guadilla, J., Seijas, R., & Andia, I. (2009). Nonunions treated with autologous preparation rich in growth factors. Journal of orthopaedic trauma, 23(1), 52–59.
Sánchez, M., Fiz, N., Azofra, J., Usabiaga, J., Aduriz Recalde, E., Garcia Gutierrez, A., Albillos, J., Gárate, R., Aguirre, J. J., Padilla, S., Orive, G., & Anitua, E. (2012). A randomized clinical trial evaluating plasma rich in growth factors (PRGF-Endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis. Arthroscopy: the journal of arthroscopic & related surgery: official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 28(8), 1070–1078.
Slater, M., Patava, J., Kingham, K., & Mason, R. S. (1995). Involvement of platelets in stimulating osteogenic activity. Journal of orthopaedic research: official publication of the Orthopaedic Research Society, 13(5), 655–663.
United States Pharmacopeia Convention. (2008). 797 Guidebook to pharmaceutical compounding-sterile preparations.
Werner, S., & Grose, R. (2003). Regulation of wound healing by growth factors and cytokines. Physiological reviews, 83(3), 835–870.
Whitman, D. H., Berry, R. L., & Green, D. M. (1997). Platelet gel: an autologous alternative to fibrin glue with applications in oral and maxillofacial surgery. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 55(11), 1294–1299.
Ziegler, C. G., Van Sloun, R., Gonzalez, S., Whitney, K. E., DePhillipo, N. N., Kennedy, M. I., Dornan, G. J., Evans, T. A., Huard, J., & LaPrade, R. F. (2019). Characterization of Growth Factors, Cytokines, and Chemokines in Bone Marrow Concentrate and Platelet-Rich Plasma: A Prospective Analysis. The American journal of sports medicine, 47(9), 2174–2187.
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