Platelet-rich Plasma (PRP) in the Treatment of Open Heart Wounds in the Sternum Area

Introduction: Median sternotomy and steel wires for sternum fastening is the standard approach to heart surgery. Incomplete repair combined with the movement of the chest wall, especially in the presence of predisposing factors, can lead to life-threatening deep-wound sternum infection, also known as mediastinitis, in ۲ to ۵ percent of cases. Despite current antibiotic and surgical treatments, mediastinitis is associated with a mortality rate of ۱۰ to ۴۰ percent and a significant increase in complications and hospitalization, mainly due to the entry of pathogens through postoperative ulcers. One of the new ways to treat these wounds is to use PRP. Methods: We conducted an extensive search across electronic databases, including PubMed, Medline, Embase, Google Scholar, and ResearchGate, and explored the available English-language literature. The mesh terms were 'Platelet-rich plasma (PRP)', 'Open heart ulcers in the sternum area', and 'Prevention of mediastinitis'. Result: PRP is a biological product made from the patient's blood and collected through centrifuges. That makes it possible to extract plasma with platelet concentrations up to five times higher than normal blood. In tissue repair and wound healing, which is based on the fact that protein substances such as cytokines, interleukins, platelet growth factor, insulin-like growth factor, fibroblast growth factor, and other growth factors present in this solution can contribute to the phenomenon of repair in body tissues and angiogenesis. This process is guided by substances secreted from platelets. It also plays a role in this type of gel treatment in bone repair. PRP gel ensures a slow release of growth factors, an increase in mesenchymal stem cells, and a safe sternum healing process. In addition, when PRP is combined with fibrin or thrombin along with calcium, it provides a lower rate of infections without side effects. Conclusion: According to the review, utilizing PRP to treat wounds post cardiovascular surgery significantly decreases the likelihood of mediastinitis in patients, while remaining cost-effective and user-friendly. Despite these promising findings, the limited number of studies available, coupled with small group sizes, raises concerns regarding the potential for bias and limits the level of evidence. To ensure the validity and effectiveness of this treatment, additional research must be conducted, including larger and higher-quality studies.

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Platelet-rich Plasma