Marlovits S, Mousavi M, Gäbler C, Erdös J, Vécsei V
Department of Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090-Vienna, Austria.
Eur Spine J. 2004 Oct;13 Suppl 1(Suppl 1):S102-6. doi: 10.1007/s00586-004-0715-3. Epub 2004 Jun 22.
A possible strategy to promote the wound-healing cascade in both soft and hard tissues is the preparation of an autologous platelet-rich plasma (PRP) to encourage the release of growth factors from activated platelets. In this process, PRP combines the advantage of an autologous fibrin clot that will aid in hemostasis as well as provide growth factors in high concentrations to the site of a tissue defect. The PRP preparation can be used as a biological enhancer in the healing of fractures and lumbar fusions. The local application of growth factors seems to promote initiation and early maturation of bone formation. Autologous bone or bone substitutes can be added to this mixture to increase the volume of grafting material. A simplified technique utilizing a commercially available separation system (GPS-Gravitational Platelet Separation System) is described. This system provides a less costly alternative to other previously described augmentation techniques and also presents a patient-friendly and operator-safe alternative. Further experimental studies of the actual concentrations of the growth factors in the PRP samples are necessary in order to validate the platelet concentration and growth-factor activation by laboratory evidence. In further prospective clinical trials, the safety and efficacy of PRP, in combination with autologous bone or bone graft substitutes, must be evaluated.
促进软组织和硬组织伤口愈合级联反应的一种可能策略是制备自体富血小板血浆(PRP),以促使活化血小板释放生长因子。在此过程中,PRP兼具自体纤维蛋白凝块的优势,既能帮助止血,又能向组织缺损部位提供高浓度的生长因子。PRP制剂可作为骨折愈合和腰椎融合术中的生物增强剂。生长因子的局部应用似乎能促进骨形成的启动和早期成熟。可向该混合物中添加自体骨或骨替代物,以增加移植材料的体积。本文描述了一种利用市售分离系统(GPS-重力血小板分离系统)的简化技术。该系统为其他先前描述的增强技术提供了成本更低的替代方案,同时也是一种对患者友好且对操作者安全的选择。为了通过实验室证据验证血小板浓度和生长因子激活情况,有必要对PRP样本中生长因子的实际浓度进行进一步的实验研究。在进一步的前瞻性临床试验中,必须评估PRP与自体骨或骨移植替代物联合使用的安全性和有效性。