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211 A CLINICAL STUDY OF THE EFFICACY OF THE THERAPEUTIC APPLICATION OF PLATELET-RICH PLASMA GEL ON THE SAPHENOUS VEIN HARVEST SITE IN CORONARY ARTERY BYPASS GRAFTING.
  1. L. E. Greiten,
  2. J. Copeland III,
  3. R. Bose,
  4. G. Sethi
  1. Department of Cardiothoracic Surgery, University of Arizona College of Medicine, Tucson, AZ

Abstract

The application of platelet-rich plasma gel (PRP) to surgical wounds has been advocated during the past 11 years; however, very few studies of the efficacy of PRP gel have been performed within the cardiovascular surgery arena. Patients undergoing coronary artery bypass grafting (CABG), in which the saphenous vein is harvested, have a 10 to 20% risk of wound complications to the leg. Application of PRP provides hyperphysiologic levels of growth factors to the wound, with perceived benefits including less patient discomfort, shorter hospital stays, and a decreased incidence of postoperative surgical site infection. Publication of the data has the potential to impact the use of PRP gel in the cardiothoracic setting and beyond. The study's protocol dictates that the patient is used as their own control, with PRP being applied to specified incision sites during the time of surgery. To date, 14 patients (7 diabetics) have been enrolled, 31 sites used as control, and PRP application to 38 sites. Evaluations are made beginning 24 hours postoperatively addressing issues of pain, numbness, erythema, infection, swelling, and general healing. Both qualitative and quantitative evidence offer diminutive substantiation to warrant PRP application. However, the goal of the study is to evaluate patients for a minimum of 6 weeks postoperatively in order to comprehensively determine any benefits. There have been no incidences of infection in either control or application site, and only one incidence of delayed/accelerated healing has been observed in a patient with pitting peripheral edema beginning 3 days postoperatively. Ultimately, a patient population of 30 to 40 individuals are to be followed from which more conclusive results can be obtained.

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