Topic

[Surgery]  LPRF,APRF,I/FPRF


Hello everyone, I have been attempting some grafting cases using sticky bone/PRF block graft and results are not great so far.  

I think one of the issue is overheating of the centrifuge and resulting poor quality PRF and not being able to achieve the right consistency for I/FPRF so that the bone actually become rock hard (using osteoss from Hiossen and Nexiva)

Q1:  For all of you doing APRF and F/IPRF, how many centrifuges do you use?

Q2:  I have one of the original Hettich centrifuge and thinking I need a 2nd and maybe even 3rd machine: any advise/thoughts on which machine to purchase? 

Q4:  Based on my experience so far, it seems necessary to do trial F/IPRF trial to see what spin time that patient actually needs: 3mins+/- @ 1700  Am I missing something here?

Q4:  I have tried cooling the centrifuge between spins in a freezer, using ice packs, compressed cold air with some success.

Thanks for any advise you may have to offer,

Anand




by Anand Choubal at Tue, May 16, 2017 11:44 AM

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Mark Kwon Replied at Thu, May 18, 2017 8:06 PM

Dear Anand,


Thanks for the uploads. 

A1. I have 2 centrifuges. All of them from Centrifugan , Germany. (Surgical Smart distribution)

A2. I recommend newer version of centrifugan if you are getting second one. (One that look like a rice cooker



Likes : 3

Bernard Jin Replied at Thu, May 18, 2017 9:46 PM

Hello Anand

Thank you for your questions.

I suppose in order to properly answer your question, I would need to know which of our 3 protocols for f-PRF you are using:  SPA? SMA? DCA?  With SPA or DCA, you would only need 1 machine, technically.  With SMA, you would benefit from two machines.

I routinely use the DCA protocol, whereas Dr. Kwon uses the SMA one.  Surgical smart has excellent machines - if you desire another one.

With respect to Question 3 - yes - much depends on the patient.  But it also is largely dependent on your draw technique and supportive staff. Remember - timing is of the essence :)

In terms of the heating/cooling issue you are referring to, I have not personally noticed the need to use refrigeration or ice packs.  It seems to work out fine for me.  Mind you, with the DCA protocol, it's like an open faucet that allows me to tap into the patient's blood vessel anytime I wish... so re-drawing is not an issue.

Hope we answered your questions!  Have a great day!



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Anand Choubal Replied at Tue, May 23, 2017 6:42 AM

Thank you Mark and Bernard for your responses!

Bernard, I am using DCA with Nexiva.  The re-draw is easy enough for sure and I keep the centrifuge right next to me so it is loaded as we draw and blood spun instantly.  My first spin is always great and usually a 12 minute cycle.  It seems like after this, even though I am following the same protocol, the quality of subsequent spins decreases significantly if in the 12-15 min cycle range, unless I wait for a few hours.  Cooling the centrifuge seems to be of minimal benefit.  

As for the shorter f-PRF spins, it is never done on my first spin. Protocol remains the same (fast acceleration) but I can't seem to get the fraction that sets the bone (Osteoss) that has been prepared ahead of time with finely chopped buffy coat from LPRF.  Not sure how much of this is attributed to the possibility of an outdated/defective centrifuge or to the individual patient, although I am confident that the draw technique is solid.

Thanks for everything guys,

Anand