The effect of platelet-rich plasma on sternal healing postmedian sternotomy in patients undergoing open heart surgery

Abstract

Background Plasma is the fluid portion of blood which contains clotting factors, other proteins, and ions. Platelet-rich plasma (PRP) is defined as a volume of the plasma fraction of autologous blood with many more platelets than what is typically found in blood. The concentration of platelets and thereby the concentration of growth factors (GFs) can be 5 to 10 times greater (or richer) than usual. The aim of this study is to evaluate the effect of PRP on sternal healing post median sternotomy in patients undergoing cardiac surgery. Patients and methods A single-center, prospective, comparative study. We recruited 100 patients who were referred for open heart surgery, through median sternotomy, to our Cardiothoracic Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt between March 2020 and January 2022. Patients were divided into two equal groups; the study group where we applied topical autologous PRP to the sternal edges before sternal closure, and the control group who did not receive PRP. Results The two groups were similar in their demographics. We found no significant benefit in terms of sternal healing between the two groups assessed by measuring bone density. Superficial and deep wound infections were similar in both groups; however, we found a marked reduction in blood loss in patients who received PRP (group 1) compared with control group (group 2). Conclusion Applying PRP topically to the sternal edges following median sternotomy did not improve sternal healing of the incidence of superficial or deep sternal wound infection. It may be beneficial in reducing blood loss from the sternal edges and hence blood transfusion requirement following surgery.