Biologics in Cardiothoracic Surgery

Sternal Closure

Sternal wound infections are serious complications following median sternotomy in cardiac surgery. These infections increase morbidity, prolong hospital stays, and raise health care costs.

Infection Reduction With Biologic Adjuncts

PRP, rich in growth factors and antimicrobial peptides, has emerged as a potential adjunct to reduce infection rates and improve wound healing.

>50%

cost reduction per patient by reducing infection and readmission¹

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PRP shows promise in reducing sternal wound infections, especially in high-risk populations.

Infection Reduction With Biologic Adjuncts

Scientific Insights

Evidence from published studies indicates that PRP can play a significant role in reducing the incidence of both superficial and deep sternal wound infections, highlighting its potential as an effective adjunct in surgical care.

PRP Reduces Infection Risk

-73% deep sternal wound infections^1-3,5‍
-78% superficial sternal wound infections^1,2,4,5

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PRP Use Reduces Hospital Readmission Rate¹

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Hospital readmission rate within 30 days (per 1000 patients)

4% control
0.8% with PRP

>50% cost reduction per patient by reducing infection and readmission¹

References

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Key Takeaways

PRP shows promise in reducing sternal wound infections, especially in high-risk populations
Cost savings and reduced readmission rates were observed with PRP use
PRP shows promising results in treating non-healing sternal wounds⁶

Study Limitations

Heterogeneity in PRP preparation, application methods, and patient populations
Inconsistent results across study designs: RCTs often show no significant benefit, while retrospective studies report positive outcomes

Infection Reduction With Biologic Adjuncts

References

Patel AN, Selzman CH, Kumpati GS, et al. Evaluation of autologous platelet rich plasma for cardiac surgery: outcome analysis of 2000 patients. J Cardiothorac Surg. 2016;11:62. doi:10.1186/s13019-016-0452-9
Vermeer H, Aalders-Bouhuijs SSF, Steinfelder-Visscher J, van der Heide SM, Morshuis WJ. Platelet-leukocyte rich gel application in the prevention of deep sternal wound problems after cardiac surgery in obese diabetic patients. J Thorac Dis. 2019 Apr;11(4):1124-1129. doi:10.21037/jtd.2019.04.42
Alanwar M.I., Allam M.M., Helmy K.M. Is Platelet Rich Plasma (PRP) Injection in Sternotomy Wound Better for Healing and Pain Control? ZUMJ. 2020;26(3):455-464. doi:10.21608/zumj.2020.26772.1788
Khalafi RS, Bradford DW, Wilson MG. Topical application of autologous blood products during surgical closure following a coronary artery bypass graft. Eur J Cardiothorac Surg. 2008;34(2):360-364. doi:10.1016/j.ejcts.2008.04.026
Serraino GF, Dominijanni A, Jiritano F, Rossi M, Cuda A, Caroleo S, Brescia A, Renzulli A. Platelet-rich plasma inside the sternotomy wound reduces the incidence of sternal wound infections. Int Wound J. 2015;12(3):260-264. doi:10.1111/iwj.12087
Tashnizi MA, Alamdari DH, Khayami ME, Rahimi HR, Moeinipour A, Amouzeshi A, Seifalian AM. Treatment of non-healing sternum wound after open-heart surgery with allogenic platelet-rich plasma and fibrin glue-preliminary outcomes. Indian J Plast Surg. 2013;46(3):538-542. doi:10.4103/0970-0358.122011