Plasma-rich fibrin in neurosurgery: a feasibility research.
Acta Neurochir (Wien). 2018 Jun 06;:
Authors: Theys T, Van Hoylandt A, Broeckx CE, Van Gerven L, Jonkergouw J, Quirynen M, van Loon J
BACKGROUND: Cerebrospinal fluid (CSF) leakage represents an vital and typically difficult complication in each cranial and spinal surgical procedure. Present obtainable choices for dural closure pose inherent issues concerning security, efficacy, immunogenicity, price, and invasiveness. On this article, the usage of leukocyte- and platelet-rich fibrin (L-PRF) derived from the affected person’s personal blood is proposed to facilitate dural closure. We goal to explain the security, feasibility, and applicability of L-PRF membranes and plugs in cranial and spinal neurosurgery.
METHODS: A retrospective research reviewing scientific and surgical traits was performed in 47 sufferers in whom the usage of L-PRF was tried to bolster dural closure at a single establishment throughout 1 yr. Procedures included cranium base, posterior fossa, and spinal revision surgical procedures.
RESULTS: L-PRF membranes and/or plugs had been utilized in 44 surgical procedures. The preparation of L-PRF failed in three instances. L-PRF membranes had been used as onlay grafts to reinforce sealing or sutured right into a defect. No short-term issues associated to the usage of L-PRF had been recorded. Postoperative CSF leakage was current in two endoscopic transsphenoidal pituitary surgical procedures and in a single spinal CSF leak restore.
CONCLUSION: L-PRF is protected, cheap, and utterly autologous and could be quickly and non-invasively harvested to assist in dural closure. Theoretical benefits embody a regenerative bioactive potential, which might result in improved wound therapeutic and diminished an infection charges. These findings warrant bigger potential research to find out the potential function of L-PRF in neurosurgery.
PMID: 29872915 [PubMed – as supplied by publisher]