Platelet Gel in Podiatric Surgery
Why use Platelet Gel in foot and ankle surgery?
We have been able to reduce pain and inflammation of our foot and ankle surgery cases with the use of Platelet Gel. Orthopedic surgeons have been using this technology for joint replacements to decrease wound complications and decrease healing time, now this has been adapted for podiatric use. Our patients typically have less pain after surgery and less swelling as the Platelet Gel helps to decrease the time your body spends in the inflammatory phase of healing as well as provide a concentrated source of healing cells.
New procedures and applications include the use of Platelet Gel injections for chronic achilles tendonitis, wound care and plantar fascitis. Results have been extraordinary, please do feel free to talk to our doctors to see if this is right for your condition.
What is Platelet Gel?
“Autologous Platelet Rich Plasma” (Platelet Gel) was developed in the early 1970’s as a by-product of multicomponent pheresis. Techniques and equipment have dramatically improved through the 1990’s. This is a new procedure which utilizes the patient’s own (autologous) platelets. Briefly, here’s how the procedure works:
Approximately 150 milliliters is drawn, either pre-operatively or in the Operating Room, into a standard blood collection bag containing a citrate-phosphate-dextrose anticoagulant. There are also new machines that are able to utilize as little as 50 milliliters of blood to producePlatelet Gel. The blood is then centrifuged by using a variable-speed centrifuge autotransfusion machine or portable machine, to separate the buffy coat suspended in plasma from the red blood cell pack and platelet-poor plasma fraction. This is the platelet concentrate used for Platelet Gel. Depending on the initial platelet counts, it is common to achieve platelet counts in excess of over three to five (3-5) times baseline counts. Other important factors in quality of Platelet Gel are platelet viability and percent retained on the procedure. While white cell content increases 125% with selection for lymphocytes and monocytes, the inclusion of platelets and white cells appears have several beneficial aspects. White cells confer additional healing cytokines while providing antibacterial activity.
On activation with thrombin/calcium to form a coagulum, the platelets interdigitate with the forming fibrin web, developing a gel with adhesiveness and strength materially greater than the plasma alone. Thrombin/calcium also causes platelets to immediately release highly active vasoconstrictors, including beta thromboxane, serotonin and PDGF.
In addition, platelets contain many tissue growth factors. These predominant growth factors are:
- PDGF (Platelet Derived Growth Factor) – PDGF is a very powerful regulatory growth factor and a sentinel growth factor that begins nearly all wound healing. PDGF’s main function is to stimulate cell replication (mitogenesis) of healing capable stems and premitotic partially differentiated osteoprogenitor cells which are part of the connective tissue-bone healing cellular make-up. PDGF also causes replication of endothelial cells, causing budding of new capillaries (angiogenesis). PDGF exists in three forms: PDGFaa, PDGFbb, PDGFab.
- TGF (Transforming Growth Factor) – TGF regulates proliferation and differentiation of multiple cell types. TGF found in platelets is subdivided into TGFB1 and TGFB2, which are the more generic connective tissue growing factors involved with matrix formation influencing osteoblasts to lay down bone matrix through the process of osteogenesis. Also cells activated by TGFB1 and TGFB2 include fibroblasts, endothelial and osteoprogenitor cells, chondroprogenitor cells and messenchymal stem cells. A chondoroprogenitor cell will further differentiate and produce the matrix for cartilage. A messenchymal stem cell stimulated to mitose provides wound healing cells.
Other important growth factors in platelets are:
- EGF (Epidermal Growth Factor) – EGF is responsible for cell differentiation and stimulates re-epitheliation, angiogenesis and collangenase activity.
- IGF (Insulin Growth Factors) – IGF is also important in wound healing, and stimulates both proliferation and differentiated function in osteoblasts.
Autologous Platelet Gel is the Perfect Operating Sealant!
Autologous Platelet Rich Plasma (Platelet Gel), on activation with thrombin/calcium, is a fibrin tissue adhesive, having hemostatic and tissue sealing properties, is the perfect surgical sealant.
There are over 30 known growth factors to date. These Platelet Growth Factors :
- Increase tissue vascularity through increased angiogenesis – This enhances wound healing
- Are chemotactic for monocytes, macrophages, and fibroblasts – This improves the ability to fight infection
- Enhance collagen synthesis – Again enhancing wound healing
- Increase the rate of epitheal and granulation tissue production – As above
- Enhance osteogenesis
- The high concentration of leukocytes in the buffy coat add an antimicrobial effect, while wound hemostasis and lymphatic sealing provide an opportunity to eliminate post-operative drains and reduce pain
- Provides watertight seal for dural closures
- When mixed auto/allograft bone fragments, it forms a putty-like consistency ideal for packing of structural reconstructions
- Provides for an immediate surgical hemostatic agent that is biocompatible, effective and safe.
Autologous Platelet Gel:
- is safe
- is non-toxic to tissue
- is autologous
- is easily prepared
- is readily available
- is cost effective
- promotes a firm seal in minutes
- is reabsorbed by the body in days to a few short weeks
- promotes local tissue growth and repair
Stem Cell Therapy
Stem Cell Injections for Knee, Ankle Arthritis, Tendonitis, Hips, Elbows, Wrist, Hand, & More
Non-responders to conventional therapies should consider a stem cell approach before using long-term steroidal, non-steroidal treatments, and/or surgery.
At the Regenerative Center of Naples, the latest in cutting edge treatments such as amniotic stem cell injections may be used to successfully treat patients with degenerative arthritis, osteoarthritis, tendonitis, and more.
Dr. Lam discusses stem cell and injects self for healing
What is stem cell therapy?
Stem cell therapy is the use of healthy stem cells to prevent or treat a disease or a condition.
What are stem cells?
Stem cells are the fundamental cells living in the human body. Their most amazing feature is that they can become many types of cell, from skin cells to muscle, from bone to cartilage. Today, stem cells are of great interest with clinical applications.
What is amniotic stem cell injection?
For clarification, amniotic stem cells that we use are derived from the amniotic sac — not an embryo. While most people may have ethical concerns about embryonic stem cell therapy, most everyone agrees that the use of amniotic stem cell therapy raises no ethical or moral questions. Harvesting amniotic stem cells is a highly regulated procedure to help ensure the health and safety of the donors and recipients.
How does amniotic stem cell therapy work?
Stem cell treatment takes advantage of the body’s ability to repair itself. The amniotic stem cells can jump-start the healing process by creating the cells the damaged tissues need.
What benefits does amniotic stem cell treatment offer?
Amniotic stem cell therapy is very safe and effective.
Amniotic stem cells rely on naturally occurring anti-inflammatory agents and contain NO STEROIDS.
Amniotic stem cells help lubricate the cartilage since they contain hyaluronic acid (a natural lubricant of the joint)
Amniotic stem cells contain growth factors which stimulate tissue growth.
There is no risk of patient rejection with amniotic stem cells.
Amniotic fluid is a highly concentrated source of stem cells. This makes it preferable over embryonic stem cells and the patient’s own stem cells (from fat or bone marrow).
Osteoarthritis, ligament, and tendon injuries are very common problems. Stem cell therapy for knee, feet, ankles, hips, elbows, wrist, hand, etc. is a non-surgical alternative for those who suffer from pain.
Surgeries can be painful and require an extended rehabilitation time. Regenerative medicine procedures such as stem cell therapy allow the body to heal itself by providing building blocks known as stem cells that stimulate the body’s natural healing processes to work.
READ MORE ON STEM CELL THERAPY: