Application Of Platelet Rich Fibrin Matrix (PRFM) In Septorhinoplasty

Abstract

Objective:In our study, we aimed to investigate the success of Platelett-rich fibrin matrix (PRFM) septorhinoplasty cartilage graft applications obtained from the patient's own blood easily and cheaply.

 

Methods: Four patients who presented at the Otorhinolaryngology Clinic of Ankara 

Numune Training and Research Hospital underwent open technical septorhinoplasty. Preoperative 10 cc venous blood was taken into two separate biochemistry tubes and centrifuged at 3000 rpm for 12 minutes. PRFM was prepared. The cartilages taken from the septum were divided into 0.3-0.5 cm in average. Cartilages were divided into PRFM and dorsal irregularity and type were applied. 

 

Results: 2 patients were implanted PRFM-wrapped cartilage graft to the type 2 region of the other 2 patients who were implanted in the dorsal region PRFM split cartilage graft.

 

Conclusion: Although our findings were short-term in our study, considering the problems in other grafting methods used in routine, it can be a grafting method that can be used safely in PRFM-wrapped cartilage graft septorhinoplasty.

Keywords

• Septorhinoplasty,Split cartilage graft,Platen rich fibrin matrix

References

1. 1.Guerrerosantos J, Trabanino C, Guerrerosantos F. Multifragmented cartilage wrapped with fascia in augmentation rhinoplasty. Plastic and reconstructive surgery. 2006;117(3):804-12.
2. 2.Falces E, Gorxey M. Use of ear cartilage grafts for nasal tip reconstruction. Plastic and reconstructive surgery. 1972;50(2):147-52.
3. 3.Juri J, Juri C, Elías JC. Ear cartilage grafts to the nose. Plastic and reconstructive surgery. 1979;63(3):377-82.
4. 4.McKinney P. Nasal tip cartilage grafts. Annals of plastic surgery. 1978;1(2):177-83.
5. 5.Erol ÖO. The Turkish delight: a pliable graft for rhinoplasty. Plastic and reconstructive surgery. 2000;105(6):2229-41.
6. 6.Yilmaz S, Erçöçen AR, Can Z, Yenidünya S, Edali N, Yormuk, et al. Viability of diced, crushed cartilage grafts and the effects of Surgicel (oxidized regenerated cellulose) on cartilage grafts. Plastic and reconstructive surgery. 2001;108(4):1054-60; discussion 61-2.
7. 7.Cakmak O, Bircan S, Buyuklu F, Tuncer I, Dal T, Ozluoglu LN. Viability of crushed and diced cartilage grafts: a study in rabbits. Archives of facial plastic surgery. 2005;7(1):21-6.
8. 8.Daniel RK, Calvert JW. Diced cartilage grafts in rhinoplasty surgery. Plastic and reconstructive surgery. 2004;113(7):2156-71.

9. 9.Calvert JW, Brenner K, DaCosta-Iyer M, Evans GR, Daniel RK. Histological analysis of human diced cartilage grafts. Plastic and reconstructive surgery. 2006;118(1):230-6.
10. 10.Daniel RK. Diced cartilage grafts in rhinoplasty surgery: current techniques and applications. Plastic and reconstructive surgery. 2008;122(6):1883-91.
11. 11.Bateman N, Jones N. Retrospective review of augmentation rhinoplasties using autologous cartilage grafts. The Journal of Laryngology & Otology. 2000;114(7):514-8.
12. 12.Matras H. Die Wirkungen vershiedener fibrinpraparate auf kontinuitat-strennungen der rattenhaut. Osterr Z Stomatol. 1970;67(9):338-59.
13. 13.Saltz R. The use of autologous platelet-rich plasma (platelet gel) and autologous platelet-poor plasma (fibrin glue) in cosmetic surgery-Discussion. LIPPINCOTT WILLIAMS & WILKINS 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA; 2001.
14. 14.Lacci KM, Dardik A. Platelet-rich plasma: support for its use in wound healing. The Yale journal of biology and medicine. 2010;83(1):1.
15. 15.Ferrari M, Zia S, Valbonesi M, Henriquet F, Venere G, Spagnolo S, et al. A new technique for hemodilution, preparation of autologous platelet-rich plasma and intraoperative blood salvage in cardiac surgery. The International journal of artificial organs. 1987;10(1):47-50.
16. 16.Bhanot S, Alex JC. Current applications of platelet gels in facial plastic surgery. Facial plastic surgery. 2002;18(1):27-34.
17. 17.Braccini F, Tardivet L, Dohan DE. The relevance of Choukroun's Platelet-Rich Fibrin (PRF) during middle ear surgery: preliminary results. Revue de laryngologie-otologie-rhinologie. 2009;130(3):175-80.
18. 18.Kuo T-F, Lin M-F, Lin Y-H, Lin Y-C, Su R-J, Lin H-W, et al. Implantation of platelet-rich fibrin and cartilage granules facilitates cartilage repair in the injured rabbit knee: preliminary report. Clinics. 2011;66(10):1835-8.
19. 19.Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 2006 Mar;101(3):e56-60. PubMed PMID: 16504852.
20. 20.Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 2006 Mar;101(3):e37-44. PubMed PMID: 16504849.
21. 21.Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 2006 Mar;101(3):e45-50. PubMed PMID: 16504850.
22. 22.Nurden AT. Platelets, inflammation and tissue regeneration. Thrombosis and haemostasis. 2011 May;105 Suppl 1:S13-33. PubMed PMID: 21479340.
23. 23.Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allograft maturation in sinus lift. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 2006 Mar;101(3):299-303. PubMed PMID: 16504861.
24. 24.Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT. Autologous platelets as a source of proteins for healing and tissue regeneration. Thrombosis and haemostasis. 2004 Jan;91(1):4-15. PubMed PMID: 14691563.
25. 25.Choukroun J, Adda F, Schoeffler C, Vervelle A. Une opportunit?? en paro-implantologie: Le PRF2001. 55-62 p.
26. 26.Bielecki TM, Gazdzik TS, Arendt J, Szczepanski T, Krol W, Wielkoszynski T. Antibacterial effect of autologous platelet gel enriched with growth factors and other active substances: an in vitro study. The Journal of bone and joint surgery British volume. 2007 Mar;89(3):417-20. PubMed PMID: 17356164.
27. 27.Tang YQ, Yeaman MR, Selsted ME. Antimicrobial peptides from human platelets. Infection and immunity. 2002 Dec;70(12):6524-33. PubMed PMID: 12438321. Pubmed Central PMCID: 132966.
28. 28.Sheen JH. The ideal dorsal graft: a continuing quest. Plast Reconstr Surg. 1998 Dec;102(7):2490-3. PubMed PMID: 9858191.
29. 29.König F. Zur Deckung von Defecten in der vorderen Trachealwand. Berl Klin Wochenschr. 1896;33:1129-31.
30. 30.Zalzal GH, Cotton RT, McAdams AJ. Cartilage grafts--present status. Head & neck surgery. 1986 May-Jun;8(5):363-74. PubMed PMID: 3539876.
31. 31.McKinney P, Loomis MG, Wiedrich TA. Reconstruction of the nasal cap with a thin septal graft. Plast Reconstr Surg. 1993 Aug;92(2):346-51. PubMed PMID: 8337288.
32. 32.Bujia J. Determination of the viability of crushed cartilage grafts: clinical implications for wound healing in nasal surgery. Ann Plast Surg. 1994 Mar;32(3):261-5. PubMed PMID: 8192385.
33. 33.Young F. Autogenous cartilage grafts. Surgery. 1941;10:7.
34. 34.Peer LA. Diced cartilage grafts: New method for repair of skull defects, mastoid fistula and other deformities. Archives of Otolaryngology. 1943;38(2):156-65.
35. 35.Elahi MM, Jackson IT, Moreira-Gonzalez A, Yamini D. Nasal augmentation with Surgicel-wrapped diced cartilage: a review of 67 consecutive cases. Plastic and reconstructive surgery. 2003;111(3):1309-18; discussion 19-21.
36. 36.Brenner KA, McConnell MP, Evans GR, Calvert JW. Survival of diced cartilage grafts: an experimental study. Plastic and reconstructive surgery. 2006;117(1):105-15.
37. 37.Dubay DA, Wang X, Kirk S, Adamson B, Robson MC, Franz MG. Fascial fibroblast kinetic activity is increased during abdominal wall repair compared to dermal fibroblasts. Wound repair and regeneration. 2004;12(5):539-45.
38. 38.Achauer BM, VanderKam VM, Celikoz B, Jacobson DG. Augmentation of facial soft-tissue defects with AlloDerm dermal graft. Annals of plastic surgery. 1998;41(5):503-7.
39. 39.Jackson I, Yavuzer R. AlloDerm for dorsal nasal irregularities. Plastic and reconstructive surgery. 2001;107(2):553-8; discussion 9-60.
40. 40.Gryskiewicz JM, Rohrich RJ, Reagan BJ. The use of alloderm for the correction of nasal contour deformities. Plastic and reconstructive surgery. 2001;107(2):561-70; discussion 71.
41. 41.Gryskiewicz JM. Waste not, want not: the use of AlloDerm in secondary rhinoplasty. Plastic and reconstructive surgery. 2005;116(7):1999-2004.
42. 42.Kim HK, Chu LS, Kim JW, Park B, Kim MK, Bae TH, et al. The viability of diced cartilage grafts wrapped in autogenous fascia and AlloDerm® in a rabbit model. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2011;64(8):e193-e200.
43. 43.Bullocks JM, Echo A, Guerra G, Stal S, Yuksel E. A novel autologous scaffold for diced-cartilage grafts in dorsal augmentation rhinoplasty. Aesthetic plastic surgery. 2011;35(4):569-79.
44. 44.Mehta S, Watson JT. Platelet rich concentrate: basic science and current clinical applications. Journal of orthopaedic trauma. 2008;22(6):432-8.
45. 45.Petrova N, Edmonds M. Emerging drugs for diabetic foot ulcers. Expert opinion on emerging drugs. 2006;11(4):709-24.
46. 46.Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgeff KR. Platelet-rich plasma: growth factor enhancement for bone grafts. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 1998;85(6):638-46.
47. 47.Weibrich G, Kleis WK, Buch R, Hitzler WE, Hafner G. The Harvest Smart PRePTM system versus the Friadent‐Schütze platelet‐rich plasma kit: Comparison of a semiautomatic method with a more complex method for the preparation of platelet concentrates. Clinical oral implants research. 2003;14(2):233-9.
48. 48.Sclafani AP. Safety, efficacy, and utility of platelet-rich fibrin matrix in facial plastic surgery. Archives of facial plastic surgery. 2011;13(4):247-51.