What is Platelet Gel?

"Autologous Platelet Rich Plasma” (Platelet Gel) was developed in the early 1970’s as a by-product of multicomponent pheresis. Techniques and equipment have dramatically improved through the 1990’s. This is a new procedure which utilizes the patient’s own (autologous) platelets. Briefly, here’s how the procedure works:

A small amount of whole blood (approximately 50 to 120 milliliters) is drawn, either pre-operatively or in the Operating Room, into a syringe containing a citrate-phosphate-dextrose adinine. The blood is then centrifuged by using a variable-speed centrifuge autotransfusion machine or portable machine, to separate the buffy coat suspended in plasma above the red blood cell layer and below the platelet-poor plasma fraction. This is the platelet concentrate used for Platelet Gel. Depending on the initial platelet counts, it is common to achieve platelet counts in excess of over three to five (3-5) times baseline counts. Other important factors in quality of Platelet Gel are platelet viability and percent retained on the procedure. While white cell content increases 125% with selection for lymphocytes and monocytes, the inclusion of platelets and white cells appears have several beneficial aspects. White cells confer additional healing cytokines while providing antibacterial activity.

On activation with thrombin/calcium to form a coagulum, the platelets interdigitate with the forming fibrin web, developing a gel with adhesiveness and strength materially greater than the plasma alone. Thrombin/calcium also causes platelets to immediately release highly active vasoconstrictors, including beta thromboxane, serotonin and PDGF.

Related Reference Articles:

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Martin, P., et al, Growth Factors and Cutaneous Wound Repair, Progress in Growth Factor Research, 1992; 4:25-44.
Hom, David B., Maisel, Robert H., Angiogenic Growth Factors: Their Effects and Potential in Soft Tissue Wound Healing, Ann Otol Rhinol Laryngol, 1992; 101:349-354.
Herndon, D., et al, Growth Factors Local and Systemic, Archives of Surgery, 1993; 128:1227-1233.
Lind, et al, Growth Factors: Possible New Clinical Tools, Acta Orthop Scand, 1996; 67(4): 407-417.
Roberts, et al, Physiological Actions and Clinical Applications of Transforming Growth Factor-beta (TGF-beta), Growth Factors, 1993; 8:1-9.
Slater, Micheal, et al, Involvement of Platelets in Stimulating Osteogenic Activity, Journal of Orthapaedic Research, 1995; 13:655-663.
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Lozano, Teresa, Broumand, Vistaub, Marx, Robert E., Evaluation of Risk with the use of Bovine Thrombin in the Clot Initiation of Platelet Rich Plasma, 1998; 1-2.
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Editorial: Topical Platelet Growth Factor Therapy: Of Lotions and Potions, Transfusion AABB, Volume 41, October 2001, 1186-1189.

Autologous Platelet Gel:

is safe
is non-toxic to tissue
is autologous
is easily prepared
is readily available
is cost effective
promotes a firm seal in minutes
is reabsorbed by the body in days to a few short weeks
promotes local tissue growth and repair

Autologous Platelet Gel is the Perfect Operating Sealant!

Autologous Platelet Rich Plasma (Platelet Gel), on activation with thrombin/calcium, is a fibrin tissue adhesive, having hemostatic and tissue sealing properties, but differs from fibrin tissue adhesives (Fibrin Glue) in its ability to improve wound healing and enhance osteogenesis.

Current Wound Sealants

Cyanoacrylates have been used in the closure of tension-free wounds, but are limited in clinical applications. The acrylic plastic cyanoacrylates are biodegradable and bacteriostatic, and use of these short chain methyl- and ethylcyanoacrylates can result to severe histotoxic responses (neural toxicity). When longer chain butyl- and isobutylcyanoacrylates are utilized, there is an increase in inflammatory responses and foreign body giant cell reactions. When neovascularization is compromised through mechanical blockage, normal wound healing is affected. Recently, topical applications of octylcyanoacrylates have been used and reported in clinical studies. They have limited usage, and are for external use only.

Fibrin Glue - Some of the first applications of Fibrin Glue are reported by Matras in Vienna. Fibrin tissue adhesives (Fibrin Glue) involve thrombin activation of concentrated fibrinogen with the presence of Factor XIII, the plasma proteins Fibronectin and cold-insoluable Globulin, Aprotinin and Calcium Chloride.

The commercial preparation of Fibrin Glue involves cryoprecipitation of Fibrinogen from single donor or pooled homologous human blood by adding calcium and thrombin at the time of usage. A fibrin clot is produced.

Commercial preparations currently under the brand name Tissel™ (Baxter AG, Deerfield, IL) use purified clotting factors derived from pooled homologous human blood products. They have been virally inactivated by heat vaporization or solvent detergent methods. These preparations contain high concentrations of fibrinogen (70-140 mg/ml). Also Fibronectin, Factor XIII and antifibrinolytics may be included.

Also a fibrin sealant, Hemaseal© has been licensed for use in the United States. In addition, autologous cryoprecipitated fibrinogen preparations have been employed in the United States.