Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Clinical Trial on Solid 2nd Generation Platelet-Concentrates in the Management of the Chronic Osteomyelitis: An Advanced Regenerative Surgeries

Version 1 : Received: 29 November 2020 / Approved: 30 November 2020 / Online: 30 November 2020 (13:38:48 CET)

How to cite: Crisci, A.; D'Adamo, R.; Crisci, M. Clinical Trial on Solid 2nd Generation Platelet-Concentrates in the Management of the Chronic Osteomyelitis: An Advanced Regenerative Surgeries. Preprints 2020, 2020110729 (doi: 10.20944/preprints202011.0729.v1). Crisci, A.; D'Adamo, R.; Crisci, M. Clinical Trial on Solid 2nd Generation Platelet-Concentrates in the Management of the Chronic Osteomyelitis: An Advanced Regenerative Surgeries. Preprints 2020, 2020110729 (doi: 10.20944/preprints202011.0729.v1).

Abstract

The supposition is that the usage of fibrin rich in leukocytes and platelets advanced (A-PRF) in ulcerative osteomyelitis of the diabetic foot allows rehabilitation from this critical illness. In this investigation, the focus was to normalize the use of PRF in patients with osteomyelitis not amputated, to use this second generation platelet concentrate as a regeneration enabler. The researchers submitted and utilized A-PRF membranes (1300 g × 8 min) in 7 patients (all diabetics) with osteomyelitis and cutaneous injury for 6 months. The membranes, in combination with the supernatant fluid produced by stress, have been integrated into the skin lesion down to the bone after surgical debridement. The advancement of the lesions after some period of time has been analyzed. All seven subjects had a Probe-to-Bone positive assay; MRI indicated a cortico-periosteal coagulation and/or foci of cortico-spongeous osteolysis contiguous to the lesion. Gram-positive bacterium were identified in our procedures in 52% of cases. Gram+ Cocci, for example, S. Aureus (15.6%), S. Hemolytic (12.1%), S. Viridans (7.1%), and Gram-negative Bacteria, for example, Pseudomonas (10.6%), Proteus (7.8%), Enterobacter (5.7%) are present. Candida Albicans is active in 2.8%. The blood count shows no relevant differences. To date, cutaneous lesions have cured in 6 of the seven subjects treated (one patient for more than five years) without any evidence of infection or recurrence. The results obtained on our subjects indicate that PRF membranes may be a therapeutic option in this problematic disease.

Keywords

osteomyelitis; buffy coat; level of growth factors; platelet-rich fibrin; thrombocyte concentrate

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