ABSTRACT
The response of living tissue to injury is a central component in the planning of
all surgical procedures. The wound-healing process is typically divided into three
phases (inflammatory, proliferative, and remodeling) and is a complex process in which
a multitude of cellular and humoral components interact to restore a wound defect.
Platelets and their released cytokines and growth factors are pivotal in the modulation
of this entire process. Although several techniques may be used to achieve hemostasis
after initial injury, few initiate and actually accelerate tissue regeneration. Both
platelet gel and fibrin glue are effective hemostatic agents. Platelet gels, unlike
fibrin glue, have a high concentration of platelets that release the bioactive proteins
and growth factors necessary to initiate and accelerate tissue repair and regeneration.
In particular, two growth factors that play a major role in platelet gels are platelet-derived
growth factor, a powerful chemoattractant, and transforming growth factor β, which
significantly increases and stimulates the deposition of extracellular matrix. In
creating a platelet gel, autologous blood is centrifuged to produce a concentrate
high in both platelets and plasma. This concentrate can be applied to wounds, providing
hemostasis, adhesion, and enhanced wound healing. Recent techniques for the autologous
concentrating process have been streamlined, and now platelet gels are clinically
accessible to most physicians. Platelet gels have global applications in surgery and
are especially useful for the soft tissue and bony reconstructions encountered in
facial plastic and reconstructive surgery. In these applications, their use has been
associated with a decrease in operative time, necessity for drains and pressure dressings,
and incidence of complications. When applied to bony reconstruction it provides adhesion
for the consolidation of cancellous bone and comminuted fracture segments.
KEYWORD
Blood products - platelet gels - tissue sealants - fibrin glue
