Platelet-rich plasma is used in various dermatology fields ranging from aesthetics and trichology to chronic ulcer management because of its potential in wound healing. For a long time, PRP is used but there is no proper terminology available to define, describe and classify the platelet concentrate variations.
There is also a difference in PRP preparation and standardization protocols. The PRP kits available are extremely pricey making it impossible for a large population to use them.
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PRP preparation principles
The differential centrifugation process helps in PRP preparation. During the process, the acceleration force needs to be tweaked to residue-specific cellular compounds based on specific gravity.
There are generally two ways to prepare PRP concentration – the PRP method or the buffy coat method.
- By venipuncture whole blood is obtained in ACD tubes [acid citrate dextrose].
- The blood must never be chilled before or during the platelet separation.
- The blood is centrifuged using soft spin.
- The supernatant plasma holding platelets is transferred into an empty sterile tube.
- The tube is centrifuged at a hard or high spin to extract platelet concentrate.
- The rich PRP settles in the lower 1/3rd part and the rest is PPP [platelet-poor plasma].
- Remove the upper 2/3rd PPP and swing the platelet pellets at the bottom with a gentle shake.
Buffy coat method
- The Whole Blood is stored before centrifugation at 20° to 24°C.
- WB is centrifuged at high speed.
- Because of concentration three layers are formed. The top layer is PPP, the middle layer is platelets, and the bottom is RBC.
- Remove supernatant plasma and transfer it to an empty sterile container.
- To separate the WBCs centrifuge at a low speed. You can even use a leucocyte filtration filter.
You will not find any clarity on whether to activate the PRP before application with calcium or thrombin or not for better results. It is a debatable question.
PRP preparation challenges
Commercially marketed PRP kits have saturated the market. It is difficult to find out which offers better PRP concentration. The systems widely differ in the collection and extraction of platelets during centrifugation. So, suspensions with different platelets & leucocytes concentration are obtained. It can influence the growth factor intensification. Therefore, the PRP preparation process is crucial.
Lots of protocols are available defining the optimum centrifugation conditions. The protocols are optimized based on WB sampling volume, spin number, centrifugation time, and extent of centrifugal speeding up. As PRP is an analogous product there is a necessity for quality control to replicate consistent results.
Some factors like blood draw, coagulant use, and centrifugation process time, speed, and temperature influence the PRP yield. The clinician has to decide the amount of PRP that can be generated from a specific method.
So, understand centrifugation’s basic principle because it plays a crucial role in PRP preparation. Use a trial & error approach because vigilance in sterility maintenance and regularly cross-checking platelet values is a MUST to replicate consistent outcomes.