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Anales de Otorrinolaringología Mexicana

2017, Number 3

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Otorrinolaringología 2017; 62 (3)

Growth factor-rich platelet plasma in the endoscopic reconstruction of anterior skull base

Andrade-Lozano P, Salas-Galicia JE, Chávez-Méndez M, Gutiérrez-Vargas R, Vélez-Castillo R, Chávez-Anaya I

Language: Spanish
References: 17
Page: 156-164
PDF size: 384.83 Kb.


ABSTRACT

Background: The rich platelet plasma (RPP) or growth factor-rich platelet plasma (GFRPP) is an autologous concentration of human platelets in a low volume human plasma that contains a huge amount of tissular growth factors. A unanimous opinion exists about the advantages of its usage as a biological adhesive.
Objetive: To determine the usefulness of RPP or GFRPP as an autologous biological fibrillar adhesive in patients subject to anterior skull base reconstruction and cerebrospinal fluid (CSF) leaks repair.
Material and Method: A descriptive, retrospective study in which autologous venous blood was used and centrifuge was done until RPP and GFRPP were obtained, the least is activated with calcium chloride. The free grafts (fat, free turbinate graft, cartilage, bone or fascia) were submerged in the previously activated GFRPP before its placement. In the case of pediculated flaps, the GFRPP was directly applied with endoscopy.
Results: Twenty patients were included to which rich platelet plasma was applied for multilayer anterior skull base reconstruction, achieving CSF leak closure in 100% at the very first attempt. Less time for cicatrization and custring formation was observed, avoiding the use of homologous fibrillar adhesives decreasing surgical risks and costs.
Conclusion: Platelets are a natural angiogenic growth factors reservoir, activating at tissular lesion sites, promoting revascularization and healing. These factors can be extracted, providing a less cost and more secure alternative to the use of recombinant or animal products.


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