Sclafani Anthony P, McCormick Steven A
Division of Facial Plastic Surgery, Department of Otolaryngology, The New York Eye and Ear Infirmary, 310 E 14th Street, New York, NY 10003, USA.
Arch Facial Plast Surg. 2012 Mar-Apr;14(2):132-6. doi: 10.1001/archfacial.2011.784. Epub 2011 Oct 17.
To evaluate the histological changes induced in human skin by injection of autologous platelet-rich fibrin matrix (PRFM).
Four healthy adult volunteers were included in the study. Platelet-rich fibrin matrix was prepared from 9 mL of autologous blood using a proprietary system (Selphyl; Aesthetic Factors, Wayne, New Jersey) and injected into the deep dermis and immediate subdermis of the upper arms of subjects. Full-thickness skin biopsy specimens were taken from the treated areas over a 10-week period, and the specimens were processed for histological evaluation.
Findings from histological examination supported the clinical observation of soft-tissue augmentation. As early as 7 days after treatment, activated fibroblasts and new collagen deposition were noted and continued to be evident throughout the course of the study. Development of new blood vessels was noted by 19 days; also at this time, intradermal collections of adipocytes and stimulation of subdermal adipocytes were noted. These findings became more pronounced over the duration of the study, although the fibroblastic response became much less pronounced. No abnormal mitotic figures were observed at any point, and a very mild chronic inflammatory response was noted only at the earliest time points of the study.
Injection of PRFM into the deep dermis and subdermis of the skin stimulates a number of cellular changes that can be harnessed for use. Coupled with prior in vitro and in vivo studies, we now have a much clearer picture of the cellular effects of PRFM and its potential uses in facial plastic surgery. Further work is planned to more clearly elucidate the potential role of PRFM in aesthetic and reconstructive surgery.
评估注射自体富血小板纤维蛋白基质(PRFM)对人体皮肤诱导的组织学变化。
本研究纳入了4名健康成年志愿者。使用专有系统(Selphyl;美学因子公司,新泽西州韦恩市)从9毫升自体血液中制备富血小板纤维蛋白基质,并将其注射到受试者上臂的真皮深层和紧邻的皮下组织。在10周内从治疗区域获取全层皮肤活检标本,并对标本进行组织学评估。
组织学检查结果支持软组织增厚的临床观察。早在治疗后7天,就观察到活化的成纤维细胞和新的胶原蛋白沉积,并且在整个研究过程中持续明显。在19天时观察到新血管形成;此时,还观察到真皮内脂肪细胞聚集和皮下脂肪细胞受到刺激。尽管成纤维细胞反应在研究后期变得不那么明显,但这些发现在研究期间变得更加显著。在任何时间点均未观察到异常有丝分裂象,仅在研究的最早时间点观察到非常轻微的慢性炎症反应。
将PRFM注射到皮肤的真皮深层和皮下组织会刺激多种可利用的细胞变化。结合先前的体外和体内研究,我们现在对PRFM 的细胞效应及其在面部整形手术中的潜在用途有了更清晰的认识。计划开展进一步工作以更清楚地阐明PRFM在美容和重建手术中的潜在作用。