Platelet rich plasma (PRP) therapy is a form of regenerative medicine that utilizes autologous platelets for treatment of various medical and aesthetic issues. During PRP, a patient receives injections of their own platelet concentrate to stimulate the body’s natural healing properties. Careful PRP preparation is essential to ensure platelet viability and this is usually done with a PRP centrifuge.
So what is the best practice for centrifugation during PRP treatment? The method used to get optimal platelet concentration will depend on the kind of PRP therapy the patient needs. Using the right PRP kit for platelet activation and platelet recovery is essential for the successful administration of the treatment, as well as factors like time and speed of centrifugation force are considered in getting favorable platelet yield.
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The Science Behind Blood Composition
To better understand the process of PRP preparation, it’s important to first know the four main components of the human blood and its important functions:
- Red blood cell – Also known as RBCs or erythrocytes, they account for almost 45% of the fluid of blood. Its main role is to promote normal oxygen circulation throughout the lungs, tissues, and the rest of the body organs. RBCs contain a hemoglobin, which makes up the red color of the blood and is the agent that transports oxygen and carbon dioxide in the body system.
- White blood cell – Also called the leukocyte, WBCs are less abundant and only make up 1% of the blood cells. White blood cells are important components of the body’s immune system and they protect against infection from bacteria and viruses. There are two types of WBC: granulocytes and agranulocytes, and they each have certain roles such as creation of antibodies or identifying invaders and attacking infected blood cells.
- Plasma – It is the liquid portion of the blood and it usually contains 90% water and 10% of other substances like sugar, nutrients, protein, and other fats. Plasma helps move blood cells along with clotting factors, antibodies, and other chemicals throughout the body and maintains normal blood pH levels.
- Platelet – Platelets, or thrombocytes, contain growth factor components and nutrients that help in wound healing. When the body is scarred or injured, platelets will gather at the site to cover the injury by blood clotting and encouraging blood coagulation to prevent blood from leaking.
Most of the blood cells are derived from hematopoietic stem cells. These stem cells are abundant in the bone marrow and are capable of mutating into red blood cells, white blood cells, and platelets. The doctors who study blood have discovered many uses to this liquid and one of these advancements is the platelet-rich plasma therapy.
Understanding the Centrifugation Process for Platelet-Rich Plasma
Centrifugation is a technology that separates the blood cells from the plasma liquid. It is the first step done in PRP to harvest autologous platelets for the treatment injection. To do this, a clinician must carefully use a syringe to draw a blood sample from the patient’s arm. An anticoagulant like sodium citrate is used to avoid clotting of the blood sample after extraction.
The sample will be stored in a test tube and it will undergo centrifugation using a device that spins the blood at a rapid speed. After the centrifugation process, the red blood cells and white blood cells will visibly rest at the bottom of the tube, while the plasma will float at the top of the container.
Ideally, the platelet concentrate for PRP must be between 5 to 7 times of the average platelet concentration. Using a PRP centrifuge machine simplifies the centrifugation process and gives you a plasma sample with the high platelet count. The kits used to prepare a PRP solution may utilize different separation techniques like gel separator, buffy coat, and double spin buffy coat.
1. Gel Separator
This is one of the simplest ways to separate the plasma from the RBC and WBC. With this system, a tube will be filled with a gel substance that will isolate the platelet from the white blood cells and red blood cells through the process of osmosis.
Spinning the blood in a gel-filled tube will cause the platelet to go on one side of the gel while the blood cells remain on the other side. While this effectively separates the platelet portion from the blood cells, one downside of this system is that it can result in platelet poor plasma which means that the plasma has low platelet concentration. It usually gives 1 to 1.5 concentration of platelet after centrifugation.
2. Buffy coat
A buffy coat layer is the concentration of white blood cells and platelets that have formed at the middle of the tube after the blood is centrifuged. To do this, the test tube containing the blood sample is spun in the centrifuge device at a very fast speed. The topmost layer of the centrifuged blood contains the plasma followed by the mixture of platelets and white blood cells and the red cells at the bottom.
This system gives you the best platelet concentration that ranges from 5 to 7 times. Before proceeding with the PRP injection, you still need to remove the buffy coat from the RBC without contaminating it. Upon successful separation, you will get a plasma and leukocytes with less than 10% red blood cell count.
3. Buffy coat with a double spin
This system takes the solution from the initial buffy coat procedure for an additional soft spin. Doubling the centrifugation of the blood sample will increase its platelet concentration factor as almost pure concentrated platelets will be more likely to stay in the plasma layer for a better PRP solution. This process can completely remove the red blood cells so the concentration of the platelets will be even higher.
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Factors That Can Affect the Centrifugation Process
Blood platelet centrifugation is an important process of PRP preparation and it must be done efficiently to bring out the essential growth factors that make the platelet treatment work. Likewise, it’s important to have complete knowledge and understanding of the practice to make sure that you properly administer the PRP injection.
That is why it is also a must to know the other factors that can affect the final platelet sample. Getting the desired concentration of the platelet-rich plasma solution may also depend on variables such as:
1. Method of spinning
There are two common types of spinning technique: single spin and double spin. The gel system utilizes a single spin technique where the process of osmosis creates a barrier that isolates the blood cells and the plasma.
On the other hand, a double spin takes the blood for an initial hard spin to break up the RBC, WBC, and the plasma. This is followed by a second softer spin which further stratifies the blood components and enriches the concentration of the platelet.
Some practitioners report that kits that use the single spin method do not produce as much concentration since the gel only separates platelets of a specific density. Only the blood platelets that are of similar weight to the gel may be isolated during the centrifugation which leaves other platelets behind. To ensure high concentration, other doctors take the blood for a second spin.
2. Centrifuge time
Most centrifuge devices rotate the blood for an average of 10 minutes. There’s a study that shows the correlation of time with the final composition of the PRP sample. In the trial, they took blood samples and initiated their first spin at a low setting for 6 and 10 min.
The products that were centrifuged for 6 minutes had relatively lower concentration results than those that were processed for 10 minutes. It can be concluded that controlling the time duration of centrifugation can affect the concentrations and platelet recovery of the PRP sample.
The force and speed of the centrifuge also has an effect on the division process of the blood. The greater the centrifugal force is exerted by the device, there will be a greater increase in the rotation which results in better separation of the platelets and blood cells. The centrifugation speed is often measured in rpm (revolutions per minute) and on average, the blood specimens are centrifuged at 3400 rpm unless stated otherwise.
Spinning the blood at high speeds can create friction and increase its heat temperature. There is a chance that the concentrated platelets sample may enter the activation phase sooner than intended if their temperature is increased. It can also result in lower viability and platelet aggregation.
Most PRP kits do not have yet the capability to control temperature; however, studies show that cooling platelets at 12°C-16°C helps achieve greater platelet recovery and maintains its efficacy.
How To Find A Good PRP Kit
There are many available centrifuge machines in the market but a good and effective PRP system is characterized by its capacity to get a potent concentration for the platelet injection. Your clinic’s PRP must have features that guarantee a smooth and successful preparation system:
1. All-in-one package
You’d want an all-in-one PRP system that already offers every component and equipment necessary for the preparation. This also lets you save on the cost since you may have to shell out additional money for other external products.
You should also consider that ease of use and the efficiency of the PRP kit. As a clinic, you want to streamline the process of gathering platelet-rich plasma so you can provide a greater level of care and service to the patients. This also makes the whole procedure easier for the staff who usually have to spend more time on blood drawing, centrifuging, and platelet extraction.
2. Provides effective separation of the blood components
A PRP kit must be able to provide you with consistent and reliable results. The treatment of PRP needs high quality concentrated platelet-rich plasma which is packed with growth factors, proteins, and other healing properties.
If the PRP centrifuge is not able to stratify the blood components, you will not get the ideal platelet count for the PRP treatment. As much as possible, you want to avoid the issue of platelet poor plasma where there is a high WBC count and low platelet concentration since this can compromise the results of the therapy.
3. Ensures safety and protection from contamination
The extraction and transferring of blood can expose the substance to external contaminants. This can affect the purity of the platelet rich plasma which likewise lessens its desirable results. An ideal system should have a design where the syringe for extraction can act as the tube so that it will only be placed in the machine for immediate centrifugation.
Another way to protect against bacteria and other outside contaminants is to choose a kit that has a cover or hood. Some processes require drawing up the buffy coat from the container and unless this is done under a venting hood, you may risk exposing the sample to harmful agents and viruses.
Learn more:What Is Included in a PRP Kit?
Common Applications of PRP Injections Today
After centrifugation, the autologous platelets will undergo platelet activation to release the proteins and growth factors needed for healing, muscle damage repair, and cell regeneration. The standard process of centrifugation is performed for the four main kinds of platelet-rich plasma therapy, namely:
- Pure Platelet-Rich Plasma (P-PRP) – Contains no WBC and low fibrin network
- Leukocyte PRP (L-PRP) – Rich in WBC count but low fibrin network
- Pure Platelet Rich Fibrin (P-PRF) – Contains no WBC but high fibrin network; it’s a more advanced type of PRP since this solution has additive agents that work to provide longer lasting results for the hair follicle and cells in the treated area
- Leukocyte Platelet Rich Fibrin (L-PRF) – Has WBC content and high fibrin network
Aesthetics clinics also offer PRP for hair loss problems among women and androgenic alopecia in men. Platelet-rich plasma therapy is injected into the scalp to improve overall scalp health and stimulates healing of hair follicle tissues which serve as the root of the hairs. It can also prevent further loss of hair by maintaining blood flow to the follicles and potentially thicken hair growth.
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Finding a reliable PRP machine may prove to be a challenge since the systems may differ in terms of their terms of usage, results, and cost. The process of blood extraction may also be intimidating to some patients. In these cases, PEP Factor products can also present as a great alternative for managing aesthetic concerns like hair loss and skin acne.
PEP Factor products contain a mixture of fibroblast growth factor compounds and copper peptide which may restore healthy hair scalp and stimulate new cell growth. It’s a readily available bio substance that can be topically applied to the area without need for any blood work and injections.
Because of its growth factors, PEP Factor may stimulate the production of collagen and elastin fibers which can help improve hair density and can enhance scalp health to reduce hair thinning. This product can be safely used as an alternative or complementary treatment to PRP and other hair regrowth therapies.
PEP Factor may also be used together with microneedling or dermabrasion therapy as a treatment option of acne problems. Its natural protein compounds may also facilitate repair of damaged and scarred skin by increasing fibroblasts to promote new collagen production. It may also be beneficial for keeping skin hydration to improve elasticity and texture that can prevent future acne breakouts.
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