Blood contains red blood cells (erythrocytes), white blood cells (leukocytes), platelets (thrombocytes), and plasma. Platelets have two main functions. One function is to contribute to the coagulation process, which helps stop bleeding. The second function is to stimulate healing when tissue damage occurs. Platelets carry many different growth factors that help initiate repair processes.

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By “filtering out” or, more correctly, centrifuging the platelets from the patient’s blood, they can be used to accelerate the healing of chronic and acute wounds. Using different centrifugation techniques, it is possible to obtain a product containing a high concentration of platelets. Usually, the term PRP -  platelet-rich plasma- is used to describe this technique. The more platelets we can deliver to the wound bed, the more growth factors will be released to stimulate healing. Some techniques achieve a concentration that contains 8-10 times more platelets per volume than in regular full blood. In normal blood there are about 200.000 platelets/ml. If we concentrate this to about 10x this means that we will have 2 billion platelets/ml  (yes, per millilitre!) in our concentrate!

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Using PRP in wound care was introduced around 1995 and has since seen a steady increase in use.  It is no longer seen as an exotic treatment, and most tissue viability clinics in the Western world have a PRP centrifuge available. In our own daily practice, we use it selectively in the right wound at the right time- this is discussed more in the following chapters. When PRP is used correctly and for the right indication, it can turn a stalled wound into a healing wound, and it can be a limb-saving procedure. 

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Note that the platelets must come from the patient themselves (autologous). Blood from other individuals cannot be used for this purpose.

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There are many techniques for producing PRP products for wound care. Most wound care centers use commercial kits to extract the platelets from the patient's blood. Each company uses a different patented technique to make the PRP product. The products differ considerably in platelet concentration, leukocyte content, and PRP consistency. Some techniques result in a round, flat fibrin clot; others result in a jelly-like clot that can fill a deep wound bed. If you have access to a high-speed centrifuge, you can prepare PRP from the patient's blood without a commercial kit. We will discuss this in the next chapter. 

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Autologous PRP products are used in many other areas of healthcare, especially in orthopedics and the cosmetic industry.

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There is considerable ongoing research aimed at developing a synthetic product containing all relevant growth factors. Some gels are available that contain individual synthetic growth factors, but they are not as effective as autologous platelets, which contain the entire spectrum of growth factors. ​​

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We have written three chapters on different aspects of PRP in wound care: an introduction to techniques for making PRP, Q&As about PRP, and finally, some tips and tricks for using PRP. Click on the images below to get to these chapters.