The wound healing effect of local leukocyte platelet-rich plasma after total hip arthroplasty: A randomized controlled trial
| Autor: | Søren Ribel-Madsen, Henrik Daugaard, Debora Marando, Arne Borgwardt, Jens Rikardt Andersen, Henrietta B L Jørgensen, Magnus S. Ågren, Peter Max Halschou-Jensen, José Salado, Pär I. Johansson, Susanne Clemen Capion |
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| Rok vydání: | 2021 |
| Předmět: |
Wound Healing
business.industry Platelet-Rich Plasma medicine.medical_treatment Arthroplasty Replacement Hip Dermatology Fascia Arthroplasty law.invention medicine.anatomical_structure Randomized controlled trial law Anesthesia Platelet-rich plasma Clinical endpoint Leukocytes Medicine Humans Surgical Wound Infection Surgery Platelet business Wound healing Whole blood |
| Zdroj: | Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair SocietyREFERENCES. 29(6) |
| ISSN: | 1524-475X |
| Popis: | Rapid wound closure is important after arthroplasty procedures to prevent postoperative complications. Platelets are rich in growth factors and leukocytes contribute to innate immunity. We hypothesized that topical leukocyte platelet-rich plasma (L-PRP) derived from the blood of patients would be beneficial to wound healing. In this randomized controlled trial, patients subjected to elective total hip arthroplasty (THA) were assigned by concealed allocation either L-PRP application onto the sutured fascia or no application (control) after the THA intervention. In addition, all patients received 1.5 g protein/kg, 5 g L-arginine, 500 mg vitamin C and 44 mg zinc daily over the 4-week postoperative period to obtain optimal nutrition. The primary endpoint was complete healing of the skin incision. The secondary endpoints were blood transfusions, length of hospital stay, pain and wound infections. Sixteen patients in the L-PRP group and 17 patients in the control group completed the trial. L-PRP treatment accelerated complete wound healing after 3 weeks (seven in the L-PRP group vs. zero in the control group, p = 0.003) and after 4 weeks (12 in the L-PRP group vs. six in the control group, p = 0.037). No postoperative superficial wound infections occurred within 4 weeks, and there were no significant differences in the other secondary outcomes. L-PRP generated in 10 sex-matched healthy volunteers revealed increased concentrations of platelets (5.8-fold) and leukocytes (2.3-fold) compared with those in whole blood. Furthermore, the concentration of keratinocyte mitogen epidermal growth factor in L-PRP (380 ± 130 pg/ml, mean ± SD) was higher (p < 0.001) than that in serum (130 ± 26 pg/ml). In conclusion, a single intraoperative local application of L-PRP promoted wound healing after THA, possibly mediated by EGF receptor agonists. |
| Databáze: | OpenAIRE |
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