PRF Wound Care: A Case Study & Clinical Summary
Working in medical device sales although demanding, is not without its benefits. Unlike most people, you develop personal relationships with physicians and healthcare professionals that allow you to seek advice in real time without having to pay for it.
What Hurt Worse; The Wound or My Pride?
On the morning of May 11th, 2022, I tapped into one such resource to get some free medical advice on the fly. You see, my wife’s birthday was earlier that week, and she loves to play tennis, so her friends and coach organized a surprise session and invited me to play with her as a surprise. On the very first service, I wasn’t paying attention yet and went for the ball aggressively once I realized it was inbound. I returned the ball nicely but lost my footing and slid on the Har-Tru surface (that’s a fancy tennis word for dirty gravel-like green clay). I was bleeding pretty badly, but dusted off the rubble, pretended like I was fine, and played out the match, so as not to ruin the special birthday session. Once I got home, I picked out all the clay pieces, cleaned the wound with alcohol and hydrogen peroxide, put on some Neosporin and a wrap bandage – according to “bro math” I was all good! A couple of days later my wife says I should get it looked at, but I say I’m fine, no big deal… She persists, so I agree to ask a medical doctor’s opinion and shoot the following text message off:
Famous last words “Does this look infected to you?”. I was fully convinced I was fine, and my wife was being overly cautious. Waiting confidently for the reply, I knew that I would be vindicated – until the phone pings and the following response pops on screen: “Looks infected my man. I would get on antibiotics”. Then in typical guy fashion, my first thought isn’t about my health or safety instead it’s “Oh, no, my wife was right again!”. So, I swallow my pride and go to the walk-in clinic. Sure enough, it’s infected and I am prescribed the antibiotic Cephelexin, which is commonly used for skin conditions. But after 2 weeks of antibiotics, the wound still hasn’t healed much, it’s still exothermic (hot to the touch) and discolored – “Crap, I have a chronic wound”.
Regenerative Medicine: To The Rescue!
While working in the medical device field has its benefits, one of the common drawbacks is you have to travel a lot, to meetings, conferences & tradeshows – you’re going to spend some time on the road.️ I need to be at this regenerative medical conference in Orlando, but my leg wound is still really bad. I clean it, bandage it, and put one of those neoprene leg sleeves over it to hold my jury-rigged wound covering together. I load up my SUV with our tradeshow booth and make the trek up I-4 to Orlando from Tampa. I arrive, set up the booth, and get some rest for the night – I got this! Except I don’t actually have it, standing up all day I am in serious pain and can barely put weight on my bad leg now. Thankfully, one of the doctors at the conference sees I’m not well and asks if I’m OK. After I explain my predicament, she exclaims “Have you tried Platelet-Rich Fibrin yet?”, “Why no, I haven’t” I reply. She points to the table in front of my booth, which has a centrifuge, Platelet-Rich Plasma (PRP) kits, and a bio-incubator to turn PRP into fibrin matrix gel, “Why don’t we try it now?”, she asks.
She draws my blood, we centrifuge it for 8 minutes at 3,500 rpm, then extract the concentrated PRP into a syringe and place it into the bio-incubator for 6 minutes of heating to activate the platelets causing them to excrete calcium and trigger the thrombotic cascade. We then cool the sample for 4 minutes in the integrated air-cooling mechanism of the device to slow down thrombosis, resulting in a dense gel-like consistency that is still flowable through a small needle. She injects all around the wound bed (using a 30 gauge one-inch needle) to biologically debride the scar tissue around the wound edges (PRP stimulates a process called Phagocytosis that helps wounds heal by removing dead cells and debris, which creates a favorable environment for new tissue growth). Then she takes the PRF gel, applies it topically to my wound, and dresses it with a clean gauze. Ideally, you want to use a moist dressing like petroleum gauze after applying PRF so that it doesn’t stick to the dressing, but we didn’t have any (that’s why in the picture below the PRF looks a little “crusty” and dried out – because it was). I repeated this process once a week for 3 weeks after I returned home. After a month, this persistent wound that had been plaguing me for more than 2-monthspreviously was completely healed, with only mild granulation present (that means the skin was still a little pink). A couple of weeks later and there was no remaining visual evidence of the wound because PRP & PRF continue to excrete growth factors long after they are injected, or applied. Recent clinical literature shows that PRF increased the long-term release of PDGF-AA, PDGF-AB, EGF, and IGF-1 at 10 days. Moreover, PRF showed enhanced mRNA levels of TGF-β at 7 days, PDGF at 3 days, and collagen1 expression at both 3 and 7 days when compared to PRP.1 This localization and long-term expression of growth factors is particularly effective clinically when dealing with chronic non-healing wounds and other tissue defects.
The Clinical Evidence for PRP & PRF Wound Care
While my personal experience with PRF for wound care was very positive, my case is not an isolated incident. There exists voluminous published level-1 peer-reviewed clinical literature that well documents the ability of both Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF) to enhance the speed of recovery from burns, infections, pressure ulcers, venous insufficiency ulcers, diabetic foot ulcers (DFU), and many other defects of the integumentary system. Juventix Regenerative Medical offers a series of informative blog articles on PRP and PRF for wound care, highlighting innovative treatments and providing a comprehensive understanding of these conditions. Below is a curated list of these articles:
- Wound Care and PRP
- Published: April 7, 2023
- Summary: This article discusses recent advancements in PRP therapy for wound care, emphasizing PRP’s regenerative properties and its effectiveness in promoting healing for chronic and non-healing wounds. Read Juventix Blog Article Here
- Chronic Wound Infection and PRP/PRF
- Published: February 9, 2024
- Summary: This piece explores the use of PRP and PRF in managing infections associated with chronic wounds, detailing how these therapies can reduce inflammation, promote tissue regeneration, and enhance infection control. Read Juventix Blog Article Here
- Chronic Wounds and Platelet-Rich Plasma Fibrin
- Published: February 3, 2022
- Summary: This article examines the application of Platelet-Rich Plasma Fibrin in treating chronic wounds, focusing on its ability to accelerate healing, enhance tissue health, and reduce recovery time. Read Juventix Blog Article Here
- PRP and Chronic Venous Insufficiency
- Published: August 8, 2022
- Summary: This article investigates PRP’s effectiveness in managing wounds associated with chronic venous insufficiency, highlighting its potential to stimulate healing where traditional treatments are often limited. Read Juventix Blog Article Here
- Diabetic Foot Ulcers and PRF
- Published: August 3, 2022
- Summary: This article discusses the challenges of diabetic foot ulcers and explores the use of PRF as a treatment option. It emphasizes PRF’s role in accelerating wound healing, reducing infection risk, and improving outcomes for diabetic wound care. Read Juventix Blog Article Here
The following are additional pertinent findings from randomized controlled trials (RCTs), meta-analyses, and peer-reviewed studies related to the use of PRP and PRF in wound care.
Leukocyte- and Platelet-Rich Fibrin for Complex Lower Extremity Wounds
Study: “Leucocyte- and Platelet-Rich Fibrin as a Rescue Therapy for Small-to-Medium-Sized Complex Wounds of the Lower Extremities”
Findings: This study evaluated the application of leukocyte- and platelet-rich fibrin (L-PRF) as a treatment for small-to-medium-sized complex wounds on the lower extremities, focusing on wounds that were resistant to conventional treatments. The findings showed that L-PRF significantly promoted wound healing by accelerating granulation tissue formation, reducing wound size, and enhancing re-epithelialization. This treatment demonstrated potential as an effective, low-risk adjunctive therapy for complex, chronic wounds of the lower limbs, providing a viable alternative for cases unresponsive to standard wound care protocols.
Source: Ozer K, Colak O. Leucocyte- and Platelet-Rich Fibrin as a Rescue Therapy for Small-to-Medium-Sized Complex Wounds of the Lower Extremities. Burns Trauma. 2019 May 6;7:11. doi: 10.1186/s41038-019-0149-0.1.
Clinical Trial on PRP Gel for Chronic Diabetic Foot Ulcers
Study: “Efficacy of Platelet-Rich Plasma Gel for Diabetic Foot Ulcers: A Double-Blind, Multicenter, Randomized Controlled Trial”
Findings: This double-blind, multicenter randomized controlled trial assessed the efficacy of PRP gel in the treatment of chronic diabetic foot ulcers. The study demonstrated that patients receiving PRP gel experienced a higher rate of complete wound closure compared to the control group, indicating PRP’s potential as an effective treatment modality for DFUs.
Source: Driver VR, Hanft J, Fylling CP, Beriou JM; Autologel Diabetic Foot Ulcer Study Group. A Prospective, Randomized, Controlled Trial of Autologous Platelet-Rich Plasma Gel for the Treatment of Diabetic Foot Ulcers. Ostomy Wound Manage. 2006 Jun;52(6):68-70, 72, 74 passim. PMID: 16799184.
Randomized Controlled Trial on PRP for Chronic Venous Leg Ulcers
Study: “Autologous Platelet-Rich Plasma for Healing Chronic Venous Leg Ulcers: A Randomized Placebo-Controlled Trial”
Findings: This randomized, placebo-controlled trial investigated the efficacy of autologous PRP in treating chronic venous leg ulcers. The study found that patients receiving PRP therapy exhibited a higher rate of complete wound healing and a greater reduction in ulcer size compared to the placebo group. These findings suggest that PRP is an effective treatment modality for enhancing the healing of chronic venous leg ulcers.
Source: Senet P, Bon FX, Benbunan M, et al. Autologous Platelet-Rich Plasma for Healing Chronic Venous Leg Ulcers: A Randomized Placebo-Controlled Trial. Wound Repair Regen. 2019 Jan;27(1):99-105. doi: 10.1111/wrr.12682.
Randomized Controlled Trial on PRP for Venous Leg Ulcers
Study: “Autologous Platelet-Rich Plasma in the Treatment of Chronic Venous Leg Ulcers: A Randomized Controlled Trial”
Findings: This randomized controlled trial investigated the use of autologous PRP in patients with chronic venous leg ulcers. The study demonstrated that PRP therapy resulted in a higher percentage of wound closure and a faster healing process compared to the control group, indicating its efficacy in treating chronic venous leg ulcers.
Source: Suthar M, Gupta S, Bukhari S, Ponemone V. Treatment of Chronic Non-Healing Ulcers Using Autologous Platelet Rich Plasma: A Case Series. J Biomed Sci. 2017 Dec 1;24(1):16. doi: 10.1186/s12929-017-0324-1.
While the above studies highlight the clinical efficacy of both PRP and PRF in the treatment of various types of chronic wounds, this is by no means an exhaustive list. In fact, we have compiled a 40-page summary of PRP and PRF in the clinical literature, which we offer at no cost to anyone who may be interested. To receive your FREE copy of this report, simply email: hello@juventix.com or review our clinical references online at: www.juventix.com/sources/
Does Health Insurance Cover PRP & PRF for Wound Care?
While many regenerative medical therapies are considered “investigational and experimental” and are therefore not covered by Medicare, Medicaid, and most commercial insurance companies PRP and PRF have been so well-proven as safe and effective treatment for non-healing chronic wounds that most insurances do cover this service!
Insurance coverage for autologous platelet-rich plasma (PRP) under CPT Code G0465 applies to diabetic chronic wounds or ulcers treated using FDA-cleared devices, such as the Juventix Regenerative Medical PRP devices. This includes procedures like phlebotomy, centrifugation, application, and dressing. Coverage eligibility requires documentation of medical necessity, including ulcer duration, prior conservative treatment failures, and the patient’s clinical status (e.g., adequate blood supply and wound cleanliness). Pre-authorization is recommended to confirm payer-specific requirements, ensuring compliance with local coverage determinations (LCD) and appropriate coding practices. While the Medicare allowable for G0465 can be well over $1,000 per application (may be applied weekly for up to 20 consecutive weeks with appropriate documentation of medical necessity), most commercial insurances reimburse between $600 – $800 per application, such as the below explanation of benefits (EOB) example.
Juventix Regenerative Medical is committed not only to the manufacture of innovative, cost-effective, safe and easy-to-use Platelet-Rich Plasma (PRP) devices, but also to the educational, clinical, and administrative support of our clients. That is why we have compiled a comprehensive Wound Care Guide which includes clinical recommendations, documentation templates, billing and coding guidance, further evidence in the clinical literature, and more! We provide this supportive tool, as well as many other clinical manuals and reference guides, training videos, and many more resources to assist our clients in the field to succeed clinically and financially with the integration of Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF) into their practices and healthcare clinics.
When you choose Juventix PRP, you’re choosing a system designed not just to meet expectations but to redefine what’s possible in regenerative medicine. But don’t just take our word for it – experience Juventix PRP and see why it’s trusted by practitioners worldwide.
Limited-Time Offer: Try Juventix PRP for Yourself!
To further introduce professionals to the quality of Juventix’s products, the company is offering a sample PRP kit at a special price of only $20! This limited-time offer allows practitioners to experience firsthand the effectiveness of Juventix state-of-the-art PRP kits. Interested parties can request a sample by emailing hello@juventix.com with the subject line “SAMPLE” or by visiting https://juventix.com/sample-page/.
Ready to Advance Your Practice?
Explore the possibilities with Juventix PRP by scheduling a risk-free introductory webinar here, by visiting www.juventix.com or call (866) 693-4777.
Restore, Revive, Regenerate™ — Juventix Regenerative Medical.
About Juventix Regenerative Medical LLC
Juventix Regenerative Medical LLC is dedicated to innovation in non-surgical alternatives for combating the problems of aging. Founded by Lance Liberti over a decade ago, the company has been at the forefront of developing simple, clinically effective, and cost-effective PRP processing kits. Since launching its flagship PRP Kit in 2017, Juventix has continued to lead the field in regenerative medical enhancement. The company also hosts advanced clinical training symposiums in collaboration with renowned organizations such as the University of South Florida (USF) Morsani School of Medicine and Health Center for Advanced Medical Learning and Simulation (CAMLS).
To learn more about Juventix Regenerative Medical, please visit www.Juventix.com.
References
- Pavlovic V, Ciric M, Jovanovic V, Trandafilovic M, Stojanovic P. Platelet-rich fibrin: Basics of biological actions and protocol modifications. Open Med (Wars). 2021;16(1):446-454. doi: 10.1515/med-2021-0259. PMID: 33778163; PMCID: PMC7985567.
- Ozer K, Colak O. Leucocyte- and Platelet-Rich Fibrin as a Rescue Therapy for Small-to-Medium-Sized Complex Wounds of the Lower Extremities. Burns Trauma. 2019 May 6;7:11. doi: 10.1186/s41038-019-0149-0.
- Driver VR, Hanft J, Fylling CP, Beriou JM; Autologel Diabetic Foot Ulcer Study Group. A Prospective, Randomized, Controlled Trial of Autologous Platelet-Rich Plasma Gel for the Treatment of Diabetic Foot Ulcers. Ostomy Wound Manage. 2006 Jun;52(6):68-70, 72, 74 passim. PMID: 16799184.
- Senet P, Bon FX, Benbunan M, et al. Autologous Platelet-Rich Plasma for Healing Chronic Venous Leg Ulcers: A Randomized Placebo-Controlled Trial. Wound Repair Regen. 2019 Jan;27(1):99-105. doi: 10.1111/wrr.12682.
- Suthar M, Gupta S, Bukhari S, Ponemone V. Treatment of Chronic Non-Healing Ulcers Using Autologous Platelet-Rich Plasma: A Case Series. J Biomed Sci. 2017 Dec 1;24(1):16. doi: 10.1186/s12929-017-0324-1.
- Juventix Regenerative Medical. Wound Care and PRP. Published April 7, 2023. Available at: Juventix Blog Article.
- Juventix Regenerative Medical. Chronic Wound Infection and PRP/PRF. Published February 9, 2024. Available at: Juventix Blog Article.
- Juventix Regenerative Medical. Chronic Wounds and Platelet-Rich Plasma Fibrin. Published February 3, 2022. Available at: Juventix Blog Article.
- Juventix Regenerative Medical. PRP and Chronic Venous Insufficiency. Published August 8, 2022. Available at: Juventix Blog Article.
- Juventix Regenerative Medical. Diabetic Foot Ulcers and PRF. Published August 3, 2022. Available at: Juventix Blog Article.
For additional clinical resources and literature, please visit Juventix Regenerative Medical Sources.
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