Platelet Rich Plasma has been used in wound healing in various medical fields for some years. Dr Christian Bisanga believes PRP may have significant benefits in hair transplantation field for the patient. Potentially PRP can benefit the two important aspects of hair transplant, the donor and the recipient area healing and improvements in skin and hair physiology post operation.
The approximate consistency of platelets in 1 cubic cm of blood is 250,000 and when concentrated with PRP can increase to 1 million, 4 times the concentration. The platelets contain the “healing” tools that are released when a wound is made. Due to the concentrated nature of PRP and the fact it can be used in specific isolated areas the platelets can react faster to the area, improving coagulation, reduce bleeding and with less fibrosis and collagen manufacture. The conclusion not just a speedier healing process but improved healing of the skin tissue reducing the signs scarring with improved healing characters.
The platelets are rich in proteins and may aid the healing in the recipient placement sites for the new grafts to rest in and the donor healing of either the linear scar with Strip surgery or punch scarring with FUE surgery. The proteins growth factors should show an increase in speed of the healing, stimulating the formation of vessels so helping the follicle to bond with the site faster and with the tissue and cardio vascular system. The fibrotic inducing proteins will enhance the conversion of fibrinogen into fibrin but in a lesser amount than naturally. This conclusion can mean a scar of visibly less size, improved laxity, less separation and angle change between follicular units, reduced miniaturisation and less collagen production between the fatty tissue and dermis layer.
The process of isolating the platelets from the blood requires taking a sample of blood from the patient. The blood is “spun” (centrifugation) at specific speeds isolating the plasma. The plasma is separated further leaving the poor and rich plasma.
The two important factors are PDGF & TGF-β. PDGF or platelet-derived growth factors stimulates cell replication of important stem cells for fibroblasts and endothelial cells (increasing “budding” on new capillaries), stimulates production of fibronectin, a cell adhesion molecule, and helps bring our wound contraction and remodelling. TGF-β stimulates fibroblasts chemotaxis and the production of collagen, while inhibiting collagen degradation by decreasing proteases and increasing protease inhibitors, all of which favour fibrogenisis. Each growth factor has the capacity to induce a unique response in the enhancement of healing; PDGF accelerated wound closure markedly through augmenting connective tissue matrix deposition and TGF-β stimulated new collagen deposition and maturation into larger bundles on the leading edge of the wound, with the likely effect of by-passing some of the inflammatory phase of wound healing. Testing is already underway on various types of wounds; a small initial test of punch donor healing on an FUE donor has shown palpable signs of speedier healing.
Dr. Bisanga wants to install correct protocols to deliver the best results for the patient. This will take time to test variants in scar closure and wound healing and other possible handling. Dr. Bisanga feels he has found medical benefits to this application but at present it will only be applied on test cases. The potential benefits to hair transplant go much further than faster and improved wound healing, this can then affect the entire hair transplant basics of donor management and potentially placement within miniaturised hair to name just two possibilities. Donor healing properties can improve the prospect for future procedures, maybe able to extend the hair numbers able to be extracted, decrease miniaturisation and improved laxity. When Dr. Bisanga feels that he can see defining benefits he will be offering PRP to his patients as an established treatment to his patients.
A thankyou to Dr. I. Meyer for his contribution and input into the research