Clinical Standardization of Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF) Treatments in Complex Wounds: A Protocol for Biological Optimization and Evidence-Based Practice

Abstract

Introduction. Complex wounds represent a critical public health challenge, requiring effective adjuvant therapies to reverse cellular senescence. Autologous platelet derivatives, namely Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF), concentrate essential growth factors to accelerate tissue regeneration. However, the lack of methodological standardization limits clinical reproducibility.

Objective. To develop and scientifically validate a structured nursing protocol for the preparation and clinical application of PRP and PRF in complex wounds.

Methods. Technical analysis and theoretical validation of institutional protocol EP431, cross-referencing operational parameters (relative centrifugal force, processing times, and handling techniques) with high-impact clinical trials.

Results. The protocol establishes a relative centrifugal force of 1500 x g for 9 minutes for PRP (separator gel tubes, inverted 5-8 times) and 700 x g for 15 minutes for PRF. Evidence confirms that these parameters maximize platelet integrity and sustained cytokine release. Intradermal/subcutaneous injection techniques (0.1 mL/cm), an optimal 4-5 day application interval, and advanced perilesional silicone barriers are detailed.

Conclusion. Clinical standardization via protocol EP431 mitigates biological variability, ensuring a safe, reproducible, and robust evidence-based intervention.