Objective

Healing of cardiac surgical wounds can become impaired by patient factors (i.e. renal failure, diabetes) and local factors (i.e. infection). Restarting a wound with impaired healing is difficult with standard wound care management (i.e. Vacuum therapy). Platelets produce secretary proteins important for wound healing. Platelet rich fibrin (PRF) is a combination of platelets and fibrin and is known to cause wound healing. The aim of this study was to analyse the efficacy of PRF in cardiac wounds.

Methods

Patients with infected sternal and saphenous harvest site wounds treated with conventional methods (i.e. Vacuum therapy) for more than two month were selected for the study. PRF was prepared using the Vivostat® processing system by taking 100 mls of the patient’s blood. This was than sprayed over the wound with an applicator. Wounds were reviewed after 1 week. Data was obtained from patients notes and serial photographs were taken to assess efficacy. Primary end point was complete wound healing.

Results

19 patients received PRF therapy (age 62±12 years). There were 8 superficial and 11 deep wounds. 10 were sternal wounds and 9 were leg wounds. Total number of PRF applications were 59 (median 2)and median duration from start of PRF application to complete wound closure was 3 weeks. 17 patients had complete wound healing. Minor complications included sinus formation (n=1) and hypergranulation (n=1), which resolved completely. Two patient undergoing PRF treatments died of unrelated causes.

Conclusion

Our study suggests that application of PRF may have sufficient efficacy to stimulate healing in chronic wounds. The results suggest that PRF may be a useful tool to treat difficult cardiac wounds and may also be cost effective as wounds’ healing is faster than conventional methods. Although we have continued to successfully treat difficult to heal wounds with PRF, a larger multicentre trial would be helpful to validate our finding.