PRP – platelet concentrates
Information and course of the meeting
P ar Dr. Yves Guglielmetti
Clinical Sports Paris V
36, Bd Saint Marcel
75005 paris 5
Before considering a platelet concentrates processing a visit is required to confirm the indication to define the therapeutic protocol, eliminating against indications and remind the precautions that surround it.
Numerous preparations on the market, variable in terms of platelet concentration, red blood cells and leukocytes, in terms of adjuvants (activator, anticoagulant), in terms of volume. Many protocols exist no scientific consensus on the ideal platelet concentrate, the number and frequency of injections, local anesthesia, the use of anti inflammatories and ice, rehabilitation and return to physical activity.
For my part, informed by my experience and scientific studies, I retained the preparation and protocol I describe below with a routine ultrasound guidance and a pain management by the inhalation of an equimolar mixture of oxygen and nitrous oxide (nitrous oxide., Kalinox system).
Before the session, it is important to point out to me any fever, infection, any skin lesion (wound), any medication taken in particular aspirin, anti-inflammatory, anticoagulant, antiplatelet agent of any allergy to iodine, a vitamin B12 deficiency or folic acid deficiency, pregnancy. The analgesia MEOPA is formally against indicated if you have recently received an ophthalmic gas, used in eye surgery.
Three injections are required at weekly intervals. In some directions a single injection is sufficient. The injection can be painful and it seems that local anesthesia impair the effectiveness of the treatment, which is why I use depending on the injection site and your tolerance to pain the MEOPA, injection PRP is then quite bearable.
Injection of platelet concentrates course of the meeting:
- 8 ml sample of blood from a vein, under stringent aseptic conditions, with a single-use equipment, closed circuit (A-PRP system RegenLab, impregnated tube sodium citrate, anticoagulant, and containing separating gel ).
- Separation of blood components, red cells, leukocytes and platelets by centrifugation for 5 minutes at 3100 rpm. Red blood cells are at the bottom (3 ml), separated by the plasma of the gel containing the wafers (5ml). The plasma is platelet rich and poor in the bottom surface plates.
- Clinical and ultrasound localization of the lesion to be treated.
- Inhalation of nitrous oxide, sedation and analgesia appears in 3 minutes
- Plasma concentration by removing 2 ml of the supernatant platelet-poor plasma.
- Series 3 ml remaining platelet rich plasma (approximately 3 times the plasma concentration) and injected into the treatment area.
- Compression of the injected area and setting up a dry dressingmaintained for 24 hours.
- Strict rest an hour waiting room
A painful reaction is usually for 2 to 3 days, imposing relative rest during which you will need if a simple analgesic (paracetamol). This preventstaking any anti-inflammatory including aspirin and applying ice for at least 15 days after injection.
Physical activity will be moderate between each session and for 3 weeks. The effect will not be felt after a few weeks. We define together a rehabilitation program and return to depending on your condition and your activities deadlines.
No infectious complications has been described in the literature. However, even if all precautions are taken, the risk inherent in any injection, can not be ruled out entirely. According to recent studies, in the conditions of realization in practice, their impact is of the order of 1 to 70,000 infection infiltration. They occur within 48 to 72 hours. In case of fever or severe pain in the days following the infiltration (possible signs of infection), it is importantContact me immediately or if your doctor.
The Health Insurance Fund does not reimburse treatment. Only one can be chosen trading infiltration as set out in the nomenclature. A prior estimate and a detailed invoice will be given. If injections of PRP related injury which was the subject of a declaration of accident insurance (leisure activity sporting license), you can claim this insurance eventual reimbursement.
Doctor Yves GUGLIELMETTI. – 23 novembre 2014.