One of the requisites of a patient’s informed consent includes the disclosure of information. So whether you’re looking to ask for a patient’s informed consent or offering the use of PRP to help solve their problems, it is important that the patients know what they want and need to know regarding PRP.
So what do you tell your patients about platelet-rich plasma (PRP) injection? You answer their frequently asked questions such as their questions on what it is, how it’s administered, its pros and cons, its costs, and whether or not it’s covered by an insurance policy. You may also offer PEP factor, a good alternative to PRP injection.
“What Is PRP?”
Platelet-rich plasma (PRP) is a regenerative injection therapy developed in the 1970s to aid in wound healing. Back then, it was meant for open-heart surgery but today, it has found a lot of applications such as dental, orthopedic, and cosmetic procedures.
PRP is primarily composed of platelets with bioactive factors such as growth factors, angiogenic factors, and immune mediators. These factors, especially the growth factors, are responsible for the healing properties of PRP. This is due to their capacity to regulate the biological processes of the cell. Some of the prominent growth factors and their functions are listed below:
|Platelet-derived growth factor (PDGF)||Promotes beneficial effects on processes governing proliferation or activation of collagen, bone cells, fibroblasts, and macrophages|
|Transforming growth factor (TGF-B)||Stimulates collagen I production, promotes the formation of new blood vessels and helps in bone remodeling|
|Vascular endothelial growth factor (VEGF)||Promotes the formation of new blood vessels, brings changes in the integrity of the endothelial cells, and stimulates the movement of WBCs such as macrophages and neutrophils|
|Epidermal growth factor (EGF)||Stimulates the mesenchymal cells and epithelial cells to grow and achieve their mature forms|
|Insulin-like growth factor (IGF)||Complements the proliferating capacities of PDGF|
|Fibroblast growth factor (FGF)||Stimulates the mesenchymal cells, chondrocytes, and osteoblasts to grow and achieve their mature forms|
“How Is PRP Administered?”
Extraction of PRP involves drawing blood from the patient’s blood vessel using a butterfly needle. This blood sample will then be subjected to centrifugation at 3,000 rpm for 15 minutes to separate the blood components (platelets, white blood cells, and red blood cells).
The concentrated platelets will then be combined with plasma. After these processes, the PRP is then ready to be injected into the patient’s area of concern. Depending on the target area, PRP may be injected intradermally, subcutaneously, or intramuscularly.
“What Are The Benefits Of PRP?”
The benefits of platelet-rich plasma therapy vary, ranging from an orthopedic application to a cosmetic procedure. The mechanism of action of PRP is said to lie in its aiding mostly in promoting the natural healing process of the body. As such, applications of PRP as a therapeutic tool include the following:
1) Post-Surgical Healing
Autologous platelet-rich plasma may be used for the improvement of post-surgical healing. Its administration is shown to improve the recovery time after surgery. As per a systematic review, the following are instances of surgeries where PRP was shown to improve the recovery from:
- It was demonstrated in a triple-blind RCT that PRP can be used as an adjunct for carpal tunnel syndrome (CTS) surgery since it showed significant functional improvement (better handgrip) and an improvement in pain 6 weeks after the reconstructive surgery.
- It was demonstrated in an open-label RCT that patients with pilonidal sinus surgeries have improved recovery upon administration of PRP compared to those who were not administered with PRP, as seen with the improvement in pain duration, return to activities, and comfort when sitting and going to the toilet.
2) Sports Injuries
Clinical evidence is available that shows that common injuries among sports enthusiasts (as well as those with an active lifestyle) may be treated with the help of platelet-rich plasma therapy. These injuries include the following:
- Tendon Injuries – Studies have shown that injection of platelet-rich plasma on animals and on humans such as patients with Achilles tendinopathy, which have shown improved recovery both cellularly and clinically. More studies are still needed regarding chronic tendon injuries and PRP injections, although initial results have been promising.
- Cartilage Injuries – Limited number of studies have been done regarding cartilage injuries although a successful outcome both on preclinical and clinical results has been noted on the intraarticular injection of PRP. For example, the rapid recovery of a soccer player with articular cartilage avulsion was observed after the use of plasma rich in growth factors.
- Musculoskeletal conditions – Results of the effects of platelet-rich plasma on muscle injuries have been promising as it showed faster healing with less formation of scarring tissue; however, more studies must be done to determine the exact route to which it must be applied and to what dose.
3) Osteoarthritis Pain
PRP is shown to help in managing pain associated with osteoarthritis. In fact, current evidence shows that PRP-treated patients show good response and better recovery time, given a proposed standardized dose of 10 billion platelets in 8 mL as compared to those that aren’t treated with PRP.
4) Hair Loss
Scientific evidence has shown that platelet-rich plasma injections may be used as a complementary procedure in addition to the hormonal effects of FDA-approved medications such as oral finasteride and topical minoxidil in helping treat androgenetic alopecia (AGA). It’s suggested that PRP be given as a subdermal depo bolus injection for purposes of effectiveness and being less painful.
5) Skin Rejuvenation
Clinical outcomes of PRP injections have shown that PRP may complement anti-aging modalities in skin rejuvenation through their concentration of growth factors that bring changes in skin cells from the genetic up to the tissue level, in that it helps in stimulating a change in gene expression in skin cells, skin cell growth, and skin tissue restructuring. They’re shown to help tighten the skin and protect skin from photoaging.
“What Are The Side Effects Of PRP?”
PRP injections are minimally invasive and thus it’s expected that those who undergo this treatment may immediately go back to their daily activities. The side effects of PRP injections don’t come from PRP per se; PRP is processed from the patient’s own blood in aseptic conditions and thus don’t put them at risk of communicable diseases from blood and allergic reaction is at a minimum. The side effects of PRP come from the injection and include the following:
- Pain – The presence of pain is indicative of inflammatory reactions especially since it’s one of the cardinal signs of inflammation. This is a typical reaction and shows that the PRP injection is working. However, should it persist up to 3 days after injection, the patient should immediately consult the doctor for evaluation.
- Infection – Infection of the injection site is extremely rare, and occurs in 1 in 10,000 injections. It is marked by fever and chills, and observable redness and heat on the area.
- Blood Clot And Bruising – Blood clots and bruising are common observations and may be caused by the trauma in the tissue of injections.
- Nerve Injuries And Tissue Damage – Unintentional injury to the adjacent nerves and tissues due to the injection needle may also occur especially when done by unskilled hands.
- No Improvement In Symptoms – No improvement in symptoms isn’t a side effect; however, it’s still worth mentioning because the patient should know that PRP injections aren’t foolproof and they should discuss other treatment options should they be unresponsive to the application of platelet-rich plasma.
“What Are The Pre- And Post-care Procedures For PRP?”
Discontinuing blood thinners and other anti-inflammatory medications before the procedure is a must because these medications hinder the efficacy of platelet-rich plasma treatment especially because of their effect on platelet activation.
However, these must be under the supervision of the patient’s primary care provider since unwarranted side effects may occur upon abrupt discontinuation of the said medications. Cold compresses must be avoided at least 72 hours after the procedure.
Other possible exposures to extreme temperatures such as hot baths and saunas should be avoided as well. The patient should also be advised not to take a bath within 24 hours after the procedure. Drinking and smoking should be advised to be avoided as well.
“How Long Do The Results Of PRP Last?”
The results of PRP may be seen between 2 to 6 weeks depending on the condition it is used for. When used for skin rejuvenation, it may take around 12 to 18 months or at least 3 PRP sessions to see the full results. PRP injections also don’t last permanently and can only last up to 18 months to 2 years, so a 1-year follow-up is needed for maintenance.
“How Much Does The PRP Cost?”
Typically, PRP treatment costs around $500 to $2,500. The cost of a single treatment of PRP may vary depending on where the patient wants to have it done, the facilities used, the expertise of the doctor performing the procedure, and the addition of other nutritive components. Additional cosmetic procedures that are to be used as adjuncts to PRP treatment such as microneedling treatment may also bring additional costs to the procedure.
“Is PRP Covered By An Insurance Policy?”
While some areas of the procedure may still be reimbursed such as the fee for the doctor’s visit, most aspects such as, for example, the cost of the special centrifuge tubes used in extracting PRP (around $800), may not be reimbursed by the insurance plan.
Moreover, platelet-rich plasma injections are yet to be approved by the FDA on most of its therapeutic claims such as in musculoskeletal injuries. They’re also categorized by insurance agencies under “investigational/experimental” and thus are usually not covered by the insurance policy and can’t be reimbursed.
“Are There Any Good Alternatives To PRP?”
There are various alternatives to PRP available depending on the problem that the patient wants to address. These include stem cells, platelet-rich fibrin (PRF), and PEP factor, with PEP Factor being the most notable due to its wide applications which are at par with PRP, while having minimal side effects.
While PRP contains growth factors and other bioactive factors contained in the alpha-granules of platelets that are the reasons behind PRP’s healing properties, PEP Factor contains fibroblast growth factor (bFGF) and copper peptide which are also responsible for PEP Factor’s beneficial effects.
Like PRP which may be used as an adjunct to other treatment modalities such as microneedling, PEP Factor may also be used as a complementary procedure to these modalities. However, unlike PRP which needs to be injected to the area of concern, PEP needs to only be topically applied, thus avoiding the side effects associated with the injection of PRP.
PEP Factor products also give the advantage of being ready-made while still giving the full benefits that PRP may bring. It doesn’t have to go through the extraction and procedures that PRP needs to undergo before it can be delivered to the patient’s body.
Get The Best PEP Factor Products At FACE Medical Supply
While it’s true that platelet-rich plasma injections have a plethora of benefits, it also brings with them a lot of side effects. It also isn’t covered by most medical insurance so it’s surely costly for most patients who want to undergo the procedure.
Offer now to your patients the beneficial PEP Factor products available at reasonable prices at FACE Med Store. Contact us today at (800) 770-9083 to learn more about our PEP Factor products or browse through our site for more hair loss treatments and tools like microcannulas and treatment serums.