The Use of Platelet-Rich Plasma (PRP) in Surgery: Antibiotic Effects and PostSurgical Rehabilitation Benefits

Introduction

Platelet-Rich Plasma (PRP) is a concentration of platelets in plasma, obtained through the centrifugation of autologous blood. Rich in growth factors and cytokines, PRP is used to promote healing in various tissues. Initially popularized in sports medicine, PRP’s applications have extended into surgical fields due to its regenerative properties. This paper reviews PRP’s use across different surgeries, its inherent antibiotic effects, and its role in post-surgical rehabilitation.

2. PRP in Various Surgical Disciplines

2.1 Orthopedic Surgery In orthopedic surgery, PRP has been widely used to enhance the healing of bone and soft tissues. Studies have shown that PRP can improve the outcomes of surgeries like rotator cuff repair, anterior cruciate ligament (ACL) reconstruction, and spinal fusion. Rotator Cuff Repair: A meta-analysis demonstrated that PRP significantly reduced re-tear rates after rotator cuff surgery, attributed to its capacity to enhance tendon healing through the release of growth factors such as platelet-derived growth factor (PDGF) and transforming growth factor-beta (TGF-β) [1]. ACL Reconstruction: Another study reported that patients receiving PRP during ACL reconstruction exhibited accelerated ligamentization and improved structural integrity of the graft, likely due to increased collagen synthesis and neovascularization [2].

2.2 Cardiothoracic Surgery PRP is utilized in cardiothoracic surgery to promote sternal healing and reduce infection rates post-sternotomy. Studies have shown that PRP application can reduce the incidence of deep sternal wound infections (DSWIs).

Sternal Healing: A study indicated that PRP application on sternal wounds significantly reduced the risk of DSWIs and enhanced wound healing by promoting fibroblast proliferation and extracellular matrix production [3].

2.3 Plastic and Reconstructive Surgery

In plastic and reconstructive surgery, PRP is used to enhance the healing of grafts and flaps, reduce scarring, and improve aesthetic outcomes.

Facial Rejuvenation: PRP has been shown to enhance facial skin rejuvenation procedures by increasing collagen production and improving skin elasticity. A randomized controlled trial found that patients treated with PRP showed significant improvement in skin texture and volume compared to controls [4]. Wound Healing: A systematic review highlighted that PRP improved the healing of chronic wounds and ulcers by enhancing angiogenesis and reducing inflammation [5].

3. Antibiotic Effects of PRP

The antibiotic properties of PRP stem from its ability to release antimicrobial peptides and enhance the host’s immune response. Several in vitro and in vivo studies have documented the antimicrobial activity of PRP against various pathogens.

Antimicrobial Activity: PRP exhibited antimicrobial effects against Staphylococcus aureus, Escherichia coli, and other common pathogens by releasing antimicrobial peptides such as thrombin and defensins [6].

Infection Reduction: A clinical study found that patients undergoing dental extractions who received PRP had significantly lower infection rates compared to those who did not receive PRP P had significantly lower infection rates compared to those who did not receive PRP, supporting its role in infection control in surgical settings [7].

4. Post-Surgical Rehabilitation Benefits

PRP’s role in post-surgical rehabilitation is primarily due to its regenerative properties, which facilitate faster recovery and improved functional outcomes.

Muscle Recovery: A study showed that PRP injections in muscle injuries accelerated muscle healing and reduced downtime, likely due to enhanced myogenesis and reduced fibrosis [8].

Joint Healing: In joint surgeries, PRP has been shown to improve the recovery of joint function and reduce pain. A randomized controlled trial reported that patients receiving PRP after knee arthroscopy experienced significantly better functional outcomes and pain relief compared to those who did not receive PRP [9].

5. Discussion

The integration of PRP into surgical practice offers significant benefits, including enhanced tissue healing, reduced infection rates, and improved rehabilitation outcomes. However, the efficacy of PRP can vary depending on factors such as the concentration of platelets, the surgical site, and patient-specific variables. Standardization of PRP preparation and administration protocols is crucial to maximizing its therapeutic potential.

Conclusions

PRP therapy presents a valuable adjunct in various surgical fields, offering both antibiotic effects and post-surgical rehabilitation benefits. While current evidence supports its efficacy, further research is needed to standardize its use and fully elucidate its mechanisms of action. As PRP technology advances, its role in surgery is expected to expand, contributing to improved patient outcomes and reduced healthcare costs.

References

1.Saltzman, B.M., Jain, A., Campbell, K.A., et al. (2018). Does the Use of Platelet-Rich Plasma at the Time of Surgery Improve Clinical Outcomes in Anterior Cruciate Ligament Reconstruction? A Systematic Review of Meta-analyses of Randomized Controlled Trials. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 34(2), 656-667.

2. Everhart, J.S., Sojka, J.H., Patel, D., et al. (2017). PRP Improves ACL Graft Maturation: A Histologic Analysis.” Orthopaedic Journal of Sports Medicine, 5(2), 2017.

3. Cabbabe, E.B., Cabbabe, S.W., & Winter, J.N. (2004). Reduction of deep sternal wound infections with platelet gel in high-risk patients.” Journal of Thoracic and Cardiovascular Surgery, 128(5), 849-856.

4. Abuaf, O.K., Simsek, G., Demircioglu, D.T., et al. (2018). The Effect of Platelet-Rich Plasma (PRP) on the Treatment of Facial Skin Wrinkles and its Application with Dermapen. Journal of Cosmetic and Laser Therapy, 20, ( 5), 270-278.

5. Etich, J., Heinemann, C., Lang, S., et al. (2017). Effects of Platelet-Rich Plasma on Wound Healing: An Updated Systematic Review and Meta-Analysis. Journal of Tissue Engineering and Regenerative Medicine, 11(8), 1775-1793.

6. Drago, L., Bortolin, M., Vassena, C., et al. (2013). ntimicrobial activity of platelet-rich plasma and other biologicals against pathogens isolated from surgical site infections. Journal of Biological Regulators and Homeostatic Agent, 27(4), 911-922.

7. Mozzati, M., Gallesio, G., di Romana, S., et al. (2007). Platelet-Rich Plasma (PRP) and Postoperative Infections in Oral Surgery: A Preliminary Reports. Journal of Oral and Maxillofacial Surgery, 65(9), 1706-1710.

8.Hamilton, B., Knez, W., Eirale, C., & Chalabi, H. (2010). Platelet enriched plasma for acute muscle injury. Acta orthopaedica Belgica, 76(4), 443–448.

9. Filardo, G., Kon, E., Buda, R., Timoncini, A., Di Martino, A., Cenacchi, A., Fornasari, P. M., Giannini, S., & Marcacci, M. (2011). Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 19(4), 528–535.