Autologous platelet-rich fibrin (PRF) augmentation as an add-on therapy in deep surgical site infections (dSSIs) after instrumented spinal surgery: preliminary results of a single institution case series

  • Background: Deep surgical site infections (dSSIs) after instrumented spinal surgery pose major therapeutic challenges. Standard treatment involves surgical debridement, wound drainage, and long-term antibiotic administration. Autologous platelet-rich fibrin (PRF) constitutes a biomaterial obtained from patients’ own blood that contains leukocytes, chemokines and growth factors boosting cicatrization. Due to favorable results reported from other surgical disciplines such as dentistry, orthopedics, maxillofacial and plastic surgery using PRF, the authors hypothesized that PRF augmentation will promote wound healing in dSSIs. Objective: To report our preliminary results on the safety and efficacy of autologous-PRF as an add-on therapy on a pilot case series of persistent dSSI after instrumented spinal surgery. Methods: Among the 293 patients who underwent dorsal decompression and stabilization of the cervical, thoracic, and lumbar spine due to degenerative diseases in our department, 12 patients (4%) presented persisting dSSI after standard wound debridement and antibiotic treatment. PRF augmentation was used during a second surgical revision as an add-on therapy to standard debridement. In all cases, the wound was primarily closed without drains. Results: Wound healing was completed between 14 and 21 days after the second surgical revision in all patients. At a median follow-up of 8 months (range: 6 to 18 months), no recurrence of dSSI nor complications were encountered in any case. Conclusions: Our preliminary results suggest that PRF augmentation in persistent dSSI after instrumented spinal surgery appears to be a safe and effective strategy to promote wound healing. Prospective controlled studies are required to define the efficiency of PRF more clearly in both treating and preventing dSSI.
Author:Ioannis Vasilikos, Roland Rölz, Christoph Scholz, Boris Mizaikoff, Katerina Argiti, Watzlawick Ralf, Georgios-Christos Giagkos, Evangelos M. Fragkakis, Shahram Michael GhanaatiORCiDGND, Jürgen Beck, Ulrich Hubbe
Parent Title (English):Acta neurochirurgica
Place of publication:Wien [u.a.]
Document Type:Article
Date of Publication (online):2021/08/24
Date of first Publication:2021/08/24
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/05/18
Tag:Autologous biomaterial; Platelet-rich fibrin; Spinal surgery; Surgical site infection
Page Number:7
First Page:2761
Last Page:2767
Open Access funding enabled and organized by Projekt DEAL.
Dewey Decimal Classification:5 Naturwissenschaften und Mathematik / 57 Biowissenschaften; Biologie / 570 Biowissenschaften; Biologie
6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0