21 Jun Intraoperative use of autologous platelet-rich and platelet-poor plasma for orthopedic surgery patients.
Volume 80, Issue 4, Page 667 (October 2004)
Kathleen M. Floryan, RN1, William J. Berghoff, MD2
•AS — USE OF AUTOLOGOUS platelet-rich plasma (PRP) and platelet-poor plasma (PPP) increases for intraoperative care of a variety of patients, it is important for perioperative nurses to recognize their benefits.
•AUTOLOGOUS PRP may decrease postoperative drainage, reduce narcotic requirements, and facilitate and early return to mobility.
•POSTOPERATIVELY, PATIENTS should experience fewer complications, recover more rapidly, and have a reduced hospital stay.
•THIS ARTICLE defines autologous PRP and PPP, describes processing and application of PRP and PPP, and reports clinical outcomes of the use of platelet concentrate for a group of patients who underwent total knee arthroplasty. AORN J 80 (October 2004) 668–674.
This program meets criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.
A minimum score of 70% on the multiple-choice examination is necessary to earn 1.6 contact hours for this independent study.
Purpose/Goal: To educate perioperative nurses about using autologous platelet-rich and platelet-poor plasma in orthopedic surgical procedures.
Editor’s note: The authors acknowledge Joel Higgins, PhD, vice president technical affairs, Cell Factor Technologies, Inc, Warsaw, Ind; and Matt Swift, MS, product development engineer, Cell Factor Technologies, Biomet, Inc, Warsaw, Ind, for technical assistance, charts, and photographs.
1 Kathleen M. Floryan, RN, MS, CNS, CNOR, is the administrator of Health-South Surgery Center, Saint Augustine, Fla.
2 William J. Berghoff, MD, is an orthopedic surgeon with Orthopaedics Northeast, Inc, Fort Wayne, Ind.
Below is an explination of “Platlet Rich Fibrin Matrix” or PRFM by a system called Cascade. I know a local orthopedic that uses this for his shoulder surgery’s. I’ve attached a video on the procedure. Read below then see my comments. 🙂
Autologous Platelet System
Interest in fibrin clot techniques and the expanded application of growth factors in soft tissue and bone repair have led to the development of the CASCADE® Autologous Platelet System which produces a Platelet-Rich Fibrin Matrix (PRFM) implant. The PRFM implant represents a potentially more precise technique to deliver a more concentrated and volume stable fibrin matrix rich in platelets. It can be delivered arthroscopically and sutured into a repair site to stimulate a healing response. Growth factors within the PRFM remain functionally viable throughout the Cascade process and are continually released over seven days.
First I think the use of PRP in surgery is a great idea. Many studies have shown that the PRP can be either injected or sprayed into or onto a surgical area to greatly assist the healing and repair. As stated above “PRP may decrease postoperative drainage (this means they don’t have to drain off extra fluid during the healing), reduce narcotic requirements (less pain), and facilitate and early return to mobility (Faster and stronger healing).” Wow that sounds pretty good to me! This sounds like it should be a standard of care on all surgery’s to enhance outcomes! We will see.
As far as the Cascade system? I wonder if this is simply an angle from a company to gain insurance dollars. There is a benefit for the surgeon to use this vs just injecting the PRP because he gets a higher paying procedure. The company producing the Cascade can then sqeeze high dollars from the insurance companies. Truth is PRP works so well with out PRFM or Cascade, many times we see even sever cases of rotator cuff tears recover, even after just one treatment. I think the arthoscopic surgery with the cascade should be a second line of defense after PRP injections are done followed by class 4 laser.