Dr. Maas talks about PRP, or platlette rich plasma, and the enthusiasm that exists for it in the medical & facial plastic surgery community as it relates to potentially improving wound healing and reducing inflamation.
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“I wanted to take a few minutes today and talk a little bit about PRP, Platelet-rich Plasma which a lot of people are talking about, not just in Plastic or Aesthetic surgery but in orthopedic surgery and neurology and many other areas in medicine. There’s a lot of exciting news about it and a lot of enthusiasm about PRP and I first of all want to explain what PRP is, everybody has an understanding about it and then talk a little bit about the science or the lack there of or as if it relates to PRP is in plastic surgery and then hair transplantation, two areas where there certainly is a lot of interest in its used.
First of all what is PRP? PRP stands for Platelet-rich Plasma. The platelets are small particles in the blood. They’re really known qualify as cells, they’re living in a sense but they don’t have a cell nucleus and they do circulate around in the blood stream with the red and the white blood cells. So that blood cells carry oxygen and white blood cells were the ones that fight infection. With PRP we’re trying to isolate these little platelet particles.
Historically platelets are thought of as particles that are responsible for starting the cascade of blood clotting and they do that by a couple of their characteristic when the blood vessel’s injured a platelet will attach to it, a really sticky and they’ll stick to that injury on blood vessels small or large and they actually is clumped together and form a lattice work essentially a plug that plugs a blood vessel up whether it’s large or small and in fact this is one of the reasons in Plastic Surgery and especially with cosmetic injections and other things what we want to have minimal bruising with minimal down time, we encourage people not to take aspirin or aspirin related products because PRP or Platelets if you will, that circulate in the blood stream are responsible for stopping in bleeding. Aspirin interestingly and non-steroidal anti-inflammatory I mentioned inhibit the aggregation or the sticking together the formation of that lattice work in platelet. So really important for people to know that, that’s the reason we ask people not to take aspirin or non-steroidal around the time of procedures or surgery so we can reduce bruising and bleeding related complications. That’s the way most people think of platelets and really it’s a very important function of platelets but we’re talking about PRP we’re actually harvesting some of the other features of it and it’s not just a platelets themselves.
PRP is really obtain from your own body so it’s an otologist system, meaning its using your own tissue in this case, the blood. A small needle is use to draw a vial or more than 1 vial of blood. The blood is span down in a centrifuge and the red blood cells which have weight go to the bottom and there’s a layer in the serum part of the test-tube then that we know is quiet rich in platelets and so this is what the term Platelet-rich plasma, plasma is the circulating non-cellular component of our blood PRP is really in that plasma, okay? So the PRP component is the layer of the serum that has the most platelets in it and we isolate that serum and platelet mixture if you will when we’re using PRP. It’s very important first of all what it is and then what it does. The platelets themselves are important because they’re involve in the clotting cascade but they also secretedinstantly a whole list of important proteins that may or may not and this is a very important point be helpful in promoting wound healing and reducing or improving or modulating in some ways the inflammatory and wound healing response and this is where all the excitement is.
So platelets are more than just a blood clotting types of particles in the blood. Every platelet itself is really just a storehouse of all kinds of growth factor and signaling molecules that we call cytokines. There’s an important in recovery and the healing tissue itself included in the list of these very important factors is one called platelet derive growth factor of PDGF which promotes blood vessel growth and cell replication and even helps with skin formation, flaming growth factor beta, TGF beta, something that we’ve had in our skin care products historically which also promotes the matrix and the really the architecture between cells and then in some ways really profoundly effects bone metabolism, there’s vascular endothelial growth factor that’s VEGF and the vascular endothelial growth factor promotes blood vessel formation so this is one of the series where we say “Well if Platelet-risk plasma has vascular and if the growth factor can it help to remote improved take of hair grafts for example?” and really unfortunately there’s no studies that approve in this but again these are important factors that Platelet-rich plasma would have in it or the platelet themselves that we’re using have in them and can be secreted.
Just a brief list I’ve gone through its platelet derive growth factor, transforming growth factor beta, vascular endothelial growth factor, there’s also epidermal growth factor or EGF fibroblast growth factor which promotes the growth of specialized cells and along with it helps with blood vessel formation and then there’s one called IGF which is really an insulin like growth factor that is important in physiology of almost all of the cells in the body and there are really many other proteins and other materials that are in serum and in the plasma that may or may not be helpful in promoting wound healing or enhancing the effects of some of the fillers, devices, products or supplies that we use or overall shortening or improving the wound healing process.
In general, the Platelet-rich plasma that platelet themselves have other proteins besides the one i’ve just discussed that may or may not improve the wound healing in the native wound healing, the efficiency of wound healing the take of grafts such as hair grafts or skin graft etcetera, the problem that we have with it right now is as much excitement and anecdote of information we have about PRP there haven’t been really well done controlled clinical trials that have shown a difference between using a blank or a placebo and comparing against a PRP combination with these various treatments. What we do know for sure in procedures like facelift and other areas where we’re lifting skin flaps is that putting platelets down in this bad can improve hemostasis, in other words reduce the amount blue ink because the platelet are activated anywhere and for this reason alone we know there is some benefit with PRP and that is in hemostasis.
The rest of the claims being made have to be substantiated by science for us to be very thoughtfully and honestly answering our patients that they’re going to be a long term benefit and while we’re all excited about it and certainly happy to write at the patients. I want to make sure everybody understands that we’re really looking for that data, there are couple of trials that are designed that are important and here already, there are others in plastic surgery that we’ll be looking to, we have a couple of designs here our self at the Maas clinic.
So if you have any other questions about Platelet-rich plasma and its use and hair transplantation or in plastic surgery even in cosmetic injections where there’s been some enthusiasm and what’s called the vampire lift please don’t hesitate to call or write. I’m always happy to answer questions, if you’ve had the experienced with PRP that you’d like to share with me or comment on it with me, have me comment on it, please don’t hesitate to share that experience. As always it’s my pleasure, this is Corey S. Maas MDTM on looking your best.”