Читать книгу Autologous Blood Concentrates - Arun K Garg - Страница 7

In many ways, traditional surgery and the medical arts have always tried to remove barriers to natural wound healing. Removal of these barriers proved that through replicable conditions and cases, standardized protocols could be created and followed to enhance wound healing. Over time, replication of results led to even more standardized techniques and procedures. For example, wound debridement and administering antibiotics demonstrably helped prevent infection, and stabilizing wounds and placing tissues in closer physical proximity promoted healing. These particular kinds of standardized, replicable surgical techniques can be labeled assistive or nonobstructive.¹ However, beginning in the last quarter of the 20th century, a truly “proactive” phase in surgical medicine began with the discovery that macrophages, reacting with oxygen, release growth factors that promote wound healing.^2–6 An assortment of cellular/tissue and oxygen-related therapies followed,^7–16 culminating only about two decades ago in the use of growth factors produced from concentrated autologous blood platelets to promote wound healing.^17–22 The result is medical science’s present focus on platelet and other biologic/regenerative therapies as critical means for promoting, initiating, and sustaining wound healing.²³

In the mid-1980s, platelets were understood essentially as cells that helped to stop bleeding. Over the next 20 years, the discovery of the various growth factors released by platelets gave birth to regenerative medical therapies, most of which are still in their infancy.^24–35 How the growth factors and functional matrix delivered by autologous blood concentrates induce wound healing is widely understood. The focus of current research is replicating and standardizing the preparation and administration of the autologous-derived product to best suit the donor-patient. Though a variety of preparation techniques, products, and nomenclatures have been tried, the good news is that no significant difference in the osteogenesis of growth factors has been evidenced.^36–40

Nevertheless, firmly establishing the science of platelet-rich plasma and other platelet-derived products requires an investigation of platelet biology, the release of growth factors, and the practical application for soft tissue healing and bone tissue regeneration. So far, the scientific journey of autologous blood concentrates has been remarkably expansive. The future of this journey promises to be more focused, even single-minded, toward its scientific destination—even more standardized products and procedures based on replicable results.