Mar 69 min read

PRP Healing Stages: Understanding the Stages of PRP Therapy

This blog serves as an informational resource for healthcare professionals delving into the advanced treatment modality of platelet-rich plasma (PRP) therapy. It aims to provide a detailed overview of PRP therapy's mechanisms, emphasizing the critical phases involved in the treatment and its recovery process. Understanding these aspects is fundamental for medical practitioners to guide their patients through informed therapeutic choices and to manage expectations regarding the healing trajectory effectively.

Within the scope of this article, we will explore the foundational principles of platelet therapy, highlighting how it utilizes the body's innate healing mechanisms to facilitate tissue repair and recovery. The discussion will focus on elucidating the key stages of the healing process post-PRP injection, offering insights into the recovery timeline and the biological underpinnings of how PRP injections contribute to tissue health and healing.

Understanding Platelet Rich Plasma

Delving into the realm of platelet therapy necessitates an understanding of its foundational principle: harnessing the body's intrinsic healing capabilities. Platelets, the cellular components critical for blood clotting, play a pivotal role in the body's repair processes. Central to platelet therapy is the concept of platelet-rich plasma (PRP), a sophisticated treatment modality that involves the extraction and concentration of platelets from the patient's own blood.

Distinct from whole blood, PRP is enriched to contain a higher density of platelets, often double the concentration found in circulating blood. This enrichment process eliminates red and white blood cells, which may contribute to inflammation and impede the healing process, ensuring that PRP delivers a potent concentration of healing components directly to the target site. [1]

Originally emerging within niches like sports medicine and maxillofacial surgery, PRP therapy has demonstrated efficacy in tendon healing, ligament healing, and supporting joint health as well as in managing chronic pain. The reports of success in these areas has broadened PRP's application across a diverse spectrum of medical fields, making it a valuable tool in numerous healthcare settings, from specialized clinics to general hospitals and outpatient facilities.

Furthermore, the autologous nature of PRP therapy—derived from the patient's own blood—significantly lowers the risk of allergic reactions and adverse complications, marking a notable advantage over other therapeutic options. This safety profile, coupled with the treatment's alignment with the body's natural healing processes, underscores the medical community's interest in PRP as a promising approach to supporting tissue repair and recovery. [2]

PRP Injection Application

The utilization of PRP therapy extends across various medical and aesthetic disciplines, underscoring its efficacy in supporting healing and recovery processes.

In musculoskeletal health, PRP therapy is applied to injuries in joints and muscles, where the injection of PRP, enriched with growth factors from platelets, aids in the repair of tissues. This process contributes to a reduction in inflammation and facilitates the natural healing mechanisms of the body, thereby improving tissue recovery, enhancing function, and alleviating pain. [3] [4]

Dermatological applications of PRP therapy involve the injection of PRP into the skin to promote collagen production, which is essential for the skin’s structural integrity. This collagen formation process supports the improvement of skin texture, assisting in the reduction of lines and the appearance of scars, leading to an improved skin appearance. [5] [6]

In addressing hair loss, PRP therapy is utilized as injection therapy to stimulate the scalp. By injecting PRP into the scalp, the procedure aims to enhance blood circulation and nutrient delivery to hair follicles, encouraging the growth of hair and strengthening existing hair strands, thus offering a potential approach for managing hair thinning and loss. [7] [8]

Orthopedic applications of PRP therapy include the delivery of growth factors to sites of bone, tendon, and ligament injuries, which can accelerate the natural repair processes of injured area, potentially reducing recovery time and alleviating discomfort in conditions such as osteoarthritis and injuries related to physical activities. [9] [10] [11]

In the field of dental and oral health, PRP therapy facilitates post-surgical healing through the promotion of tissue regeneration and optimal blood clot- formation, which is particularly beneficial following dental implant procedures and periodontal surgeries, where it can contribute to quicker recovery and reduced post-operative complications. [12] [13]

For wound care, PRP therapy enhances the body's healing process by applying PRP to wounds, supporting tissue health, and reducing inflammation. This is beneficial for chronic wounds or those that are slow to heal, as it can speed up the healing process and decrease the likelihood of infection. [14] [15]

In cosmetic procedures, PRP therapy is employed for its natural approach to improving appearance. It is used in treatments such as facelifts and under-eye adjustments, where it supports the skin's health, contributing to a refreshed look without the use of synthetic fillers or chemicals. [16] [17]

Healing Stages of PRP

The process begins with the activation of PRP, which can occur naturally upon contact with body tissues or be induced during the preparation phase. This activation initiates the release of growth factors, essential proteins that signal the body to start the healing process. These growth factors are pivotal in recruiting cellular resources to the site of injury, marking the commencement of the repair phase.

Following the release of growth factors, stem cells are attracted to the site of injury, where they undergo proliferation. This increase in cell numbers lays the groundwork for subsequent tissue repair and regeneration, as these cells replace damaged tissue and differentiate into the specific cell types required for effective healing, such as muscle, tendon, or skin cells. This differentiation ensures the restoration process is precisely tailored to the needs of the damaged tissue, aiming to replicate the original structure and function.

An integral aspect of PRP therapy is its role in modulating the inflammatory response. While inflammation is a natural component of the body's healing response, unchecked inflammation can impede the healing process and cause discomfort. PRP contains anti-inflammatory properties that help mitigate excessive inflammation, thereby reducing pain and swelling at the injury site. This modulation is beneficial for patient comfort and is essential for a smooth, uninterrupted healing process.

The final stages of wound healing often involve tissue remodeling and maturation, where the newly formed tissue undergoes structural refinement under the influence of PRP-derived growth factors. This remodeling ensures that the new tissue is correctly integrated with the existing structures to achieve optimal strength and functionality. The maturation process further strengthens the repaired tissue, enhancing its durability and reducing the likelihood of future injuries. [18]

Potential Limitations and Risks

As PRP therapy continues to gain traction across various medical disciplines, it is imperative for healthcare professionals to meticulously evaluate the existing limitations and potential risks associated with this innovative treatment modality. A comprehensive grasp of these considerations is crucial for effectively guiding patients through the decision-making process concerning PRP therapy.

1. Potential for Adverse Reactions

While PRP therapy is generally considered safe—largely due to its autologous nature—there are potential side effects, which are often mild and transient. These can include discomfort or pain at the site of the injection, a common occurrence that typically resolves shortly after the procedure. Swelling, redness, or bruising at the injection site may also be observed, with these symptoms usually subsiding within a few days.

The risk of infection inherent to any procedure involving injections is minimized through adherence to sterile techniques. Moreover, there is a potential for tissue damage if injections are not performed correctly, underscoring the importance of skilled administration. Although PRP therapy involves the use of the patient's own blood, allergic reactions may still occur, possibly due to additives or anticoagulants used during the process. [19]

2. The Importance of Trained Medical Professionals

The effectiveness and safety of PRP therapy are heavily dependent on the expertise and proficiency of those administering it. Within the field, there is a spectrum of practitioners, from highly qualified to those whose practices may not adhere to the highest standards, potentially leading to less than optimal patient outcomes and an increased risk of adverse effects.

For healthcare professionals, it is imperative to select peers and institutions that hold verifiable qualifications and a track record using effective PRP therapy applications for collaboration or referral.

3. Limited Clinical Evidence

The application of PRP therapy, despite its potential, is currently marked by a scarcity of in-depth, long-term clinical studies across its various potential applications. The variability observed in treatment outcomes, influenced by factors such as patient age, general health status, and specific medical conditions, advocates for a measured approach. Healthcare providers are tasked with staying informed about the latest research developments and communicating the current understanding of PRP therapy’s effectiveness and safety profile transparently to their patients.

4. FDA Approval

While the equipment used for PRP preparation and the procedure itself have received clearance from the U.S. Food and Drug Administration (FDA), the broader application of PRP therapy across different medical conditions is yet to receive formal FDA approval and is considered investigational. The autologous nature of PRP, derived from the patient's own red blood cells, circumvents traditional drug regulation, affording medical practitioners the discretion to employ PRP therapy based on clinical judgment and patient-specific needs, despite the lack of formal approval for certain uses. [20]

SELPHYL® Disclaimer

Instructions for the use of SELPHYL® can be found here and here.

SELPHYL® has not been approved by the FDA for subcutaneous, submucous, or intradermal injections in aesthetic medicine, and the safety and effectiveness of SELPHYL® for these conditions have not been established.

SELPHYL® is designed to be used for the safe and rapid preparation of autologous platelet-rich plasma (PRP) from a small sample of peripheral blood at the patient's point of care. The PRP is mixed with autograft and/or allograft of bone marrow prior to application to a boney defect to improve handling characteristics.

As of the time of writing, SELPHYL® has no known serious, life-threatening, or fatal risks apart from the adverse reactions described above.

SELPHYL® Limitations, Restrictions, Cautions, and Warnings

Prescription only.
Do not use the kit if the sterile packaging is damaged or compromised.
Follow universal safety precautions for blood collection and sharps disposal.
During blood draw, failure to align and properly seat tubes in the tube holder can result in a loss of vacuum and a loss of blood draw.
During PRP transfer, failure to align and securely seat tubes simultaneously in assembled blood transfer device tube holders can result in a loss of vacuum and the failure of PRP to transfer to the red-top PRFM tube.
Do not initiate the transfer of PRP into the red-top PRFM tube until the physician is ready to complete the procedure.
Do not reuse.

SELPHYL® Contraindications

These are not in FDA-required labeling and are part of SELPHYL®’s clinical evaluation for EU CE requirements.

Direct connection to a patient’s vascular system of circulating blood volume.
Other health conditions and diseases may also contraindicate the use of autologous PRP, including but not limited to low platelet count, sepsis, localized infection in the treatment area, anemia, malignancy with hematologic or bony involvement, and anticoagulation therapy.

Takeaway

PRP therapy exemplifies the remarkable capabilities of leveraging the body's intrinsic repair processes for therapeutic purposes. The underlying science of PRP treatment is intricate, yet the core premise is clear: it aims to offer a biologically based, efficacious approach to augmenting the body’s own healing responses.

Healthcare professionals considering the integration of PRP therapy into treatment regimens, whether for addressing injuries, enhancing recovery processes, or its application in aesthetic medicine, should prioritize the dissemination of comprehensive information and the provision of expert guidance. Although PRP therapy has shown potential across various applications, it should not be perceived as an immediate solution but as a component of a broader strategy aimed at supporting and possibly enhancing the body's natural healing and regenerative capacities.

About the Author

Dr. Ali is a medical journalist and copywriter employed by SELPHYL® for the writing of this article.