Platelet-Rich Plasma: Evolving Role in Plastic Surgery

Edward S. Chamata, M.D.; Erica L. Bartlett, M.D.; David Weir, N.P.-C.; Rod J. Rohrich, M.D.

Disclosures

Plast Reconstr Surg. 2021;147(1):219-230. 

In This Article

Platelet and Growth Factor Concentration

No consensus exists for platelet concentration in platelet-rich plasma. Platelet concentrations of more than 1 million/μl are generally viewed as therapeutically effective; however, the literature is lacking.[51,52] Reported platelet concentrations vary from 2- to 9-fold increase above baseline, but the ideal concentration of platelets has not been elucidated.[10,36,38,53,54]

Some studies report the platelet concentration in the platelet-rich plasma obtained; however, few report whole blood and platelet-rich plasma platelet levels.[34,39,42,49,50,55–57] A dose-response relationship exists in vitro between concentration of platelets and human adult mesenchymal stem cell production, type I collagen production, and fibroblast proliferation; however, this has not been proven with clinical studies.[58] Other studies question this dose-response relationship, theorizing that different individuals may require different platelet concentration ratios to achieve similar effects and that growth factor concentrations contained within platelets are variable between patients.[44,59,60] In addition, there is some speculation that the treatment of different conditions requires different platelet concentrations.

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