BACKGROUND: Autologous fat grafting is a mature treatment for soft tissue reconstruction, but some disadvantages such as unpredictable results and variable reabsorption still exist. Concentrated platelet products have been shown to promote adipogenesis, reduce postoperative adverse reactions, and enhance fat graft survival combined with adipocytes.
OBJECTIVE: To review the compositions, properties, research progress and clinical application of platelet-rich plasma, platelet-rich fibrin and concentrated growth factor.
METHODS: A computer-based retrieval of CNKI, WanFang, PubMed and Medline databases was performed for the articles concerning concentrated platelet products and autologous fat grafting published before 2017. The keywords were “platelet-rich plasma, platelet-rich fibrin, concentrated growth factor, fat graft, survival” in English and Chinese, respectively. Initially 940 articles were retrieved, and finally 54 eligible articles were included according to the inclusion and exclusion criteria.
RESULTS AND CONCLUSION: Platelet-rich plasma, the first generation of concentrated platelet products, has been reported to promote fat graft survival by activating various factors. However, its roles still remain controversial because of a subjective but not objective assessment. As the substitute of platelet-rich plasma, platelet-rich fibrin possesses overt advantages in manufacturing process and safety. Moreover, its unique anti-inflammatory cytokines, fibrin and sustained-release nerve growth factor achieve satisfactory effects in fat grafting. Compared with platelet-rich fibrin, the newly emerged concentrated growth factor holds CD34+ stem cells and more fibrin, and provides a three-dimensional fibrin graft, ensuring a better outcome in fat transplantation. Importantly, the newly developed concentrated growth factors gel and liquid will be extensively applied in fat transplantation. Nevertheless, assessment methods need to be improved, and CT, MRI and other radiological methods should be adopted. Additionally, more clinical controlled trials are needed to lay down a clinical guidance, so as to enhance the development of concentrated platelet products in fat transplantation.