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Background: Platelet-rich plasma (PRP) is widely used in various medical and surgical specialties for its regenerative properties, including aesthetics (facial rejuvenation, hair restoration, and skin tightening) and orthopedics (treatment of tendinitis and osteoarthritis). However, the inconsistent literature on PRP's efficacy and safety leads to critical knowledge gaps. This systematic review evaluates quality control measures in PRP preparation and application and explores the regulatory environment governing its clinical use. Methods: Following PRISMA guidelines, a comprehensive search was conducted across multiple databases, including PubMed, EMBASE, and Web of Science, for studies published from January 2020 to April 2024. The review included randomized controlled trials (RCTs) involving human participants undergoing PRP treatment for aesthetic or regenerative purposes. Key parameters such as the PRP preparation methods, platelet concentration, and quality control measures were analyzed. The study protocol was registered with PROSPERO (ID: CRD42024557669). Results: Out of 75 RCTs involving 5726 patients, the review identified significant variability in PRP preparation methods and application techniques, including differences in centrifugation protocols and platelet concentration levels. A new evidence-based scoring system, the William–Eqram Scoring System for PRP Quality Reporting (WESS-PQR), was proposed to address these inconsistencies. Correlation analysis revealed a strong positive correlation (r = 0.79) between proper temperature control during preparation and PRP efficacy. Initial platelet count assessment showed a moderate positive correlation (r = 0.57) with efficacy. Conclusions: Standardized PRP preparation protocols and robust regulatory frameworks are urgently needed to ensure the safety and efficacy of PRP treatments. The proposed WESS-PQR scoring system can serve as a valuable tool for clinicians and researchers, promoting consistency and reliability in PRP applications. [ABSTRACT FROM AUTHOR]

Background: Polynucleotides (PDRN) have gained attention in aesthetic and regenerative medicine for their potential to enhance tissue regeneration, improve skin quality, and deliver superior aesthetic outcomes. However, the transition from theoretical benefits to proven clinical outcomes faces challenges due to inconsistencies and methodological shortcomings in the existing evidence base. This systematic review aims to critically evaluate the scientific basis and empirical evidence supporting the use of PDRN in aesthetic and regenerative medicine, highlighting the quality, reproducibility, and reliability of existing research, and identifying gaps and inconsistencies within the current literature. Methods: Adhering to PRISMA guidelines and registered with PROSPERO, this review formulated a research question using the PICO framework to assess the efficacy of PDRN applications. A comprehensive literature search across PubMed–MEDLINE, EMBASE, and Web of Science was conducted. The inclusion criteria focused on clinical studies applying PDRN in regenerative or aesthetic medicine with clear outcome measures. Quality assessment utilized Cochrane Risk of Bias tool, ROBINS-I, and Newcastle Ottawa Scale. Data synthesis was qualitative due to anticipated heterogeneity. Results: From 360 identified studies, 16 clinical trials met the inclusion criteria, encompassing various study designs and a total of 750 participants. The studies investigated PDRN's efficacy across different conditions and applications. Findings revealed a lack of specificity in PDRN sequencing, molecular targets, and dosage details, with a noted variability in source and manufacturing standards. Most studies demonstrated a low risk of bias, suggesting methodological rigor, yet the absence of comprehensive reporting on sequencing, targeted mechanisms, and molecular length was evident. The review underscores the embryonic stage of PDRN research and the necessity for more rigorous studies to validate clinical outcomes. Conclusions: The potential of PDRN in aesthetic and regenerative medicine is significant, yet the current state of evidence necessitates a cautious and evidence-based approach to their clinical integration. Future research should focus on overcoming the highlighted gaps and inconsistencies, ensuring that the innovation in treatments does not compromise patient safety and efficacy. Regulatory frameworks must evolve to address the unique challenges presented by PDRN technologies, ensuring their safe and ethical application. Level of evidence: Level I, Therapeutic. [ABSTRACT FROM AUTHOR]

[Display omitted] • Novel approach to resolve scalability challenges in bioprinting vascular grafts. • Novel Growth Factor delivery system (PODS) was employed within bioprinting process. • Developed bioprinted blood vessels using adipose derived stem cells. • Successfully scaled up SMCs and ECs from adipose derive stem cells. • Bilayer assembly of bioprinted cells mimicked blood vessel structure and composition. Advancing bioprinted vascular grafts for clinical applications faces the challenge of obtaining sufficient functional endothelial cells and smooth muscle cells essential for the biofabrication of blood vessels. Accurate placement of these cells is crucial for optimal performance. Tissue engineering, particularly with adipose-derived stem cells (ADSCs), offers promising solutions. In this approach, ADSCs were cultivated and differentiated into endothelial cells (dECs) in vitro using VEGF-165 PODS® (Polyhedrin Delivery System), while smooth muscle cells (dSMCs) were differentiated in situ within the outer layer of the 3D bioprinted vessel using TGF-β1 PODS® with bioink VascuBiomatrixTM. The effect of PODS® on production of differentiated Endothelial Cells (dECs) and Smooth Muscle Cells (dSMCs) was validated through flow cytometry, immunocytochemical staining, and RT-PCR, using cell specific markers, as well as immunolabeling for extracellular collagen I and elastin. This confirmed that cells within the vessel walls retained their phenotype and secreted human extracellular matrix (ECM) components. Scanning electron microscopy (SEM) confirmed the vessels' morphology and dimensions, and tensile testing and burst pressure tests assessed mechanical properties. In vivo compatibility was evaluated by blood hemocompatibility and the CAM (Ex Ovo chorioallantoic membrane) assay. Results confirmed the successful fabrication of a bilayer blood vessel structure with smooth muscle cells and an endothelial lining, exhibiting adequate physiological properties. Hemocompatibility and in vivo CAM assays demonstrated low platelet adhesion, improved biocompatibility, and angiogenic properties. These findings suggest that integrating ADSCs and bioink for 3D bioprinting provides a practical solution for fabricating functional small-diameter vascular grafts. This study advances vascular tissue engineering through the combination of stem cells, growth factor delivery systems, and bioprinting technology. [ABSTRACT FROM AUTHOR]

An effective sterilisation technique that maintains structure integrity, mechanical properties, and biocompatibility is essential for the translation of new biomaterials to the clinical setting. We aimed to establish an effective sterilisation technique for a biodegradable (POSS-PCL) and nonbiodegradable (POSS-PCU) nanocomposite scaffold that maintains stem cell biocompatibility. Scaffolds were sterilised using 70% ethanol, ultraviolet radiation, bleach, antibiotic/antimycotic, ethylene oxide, gamma irradiation, argon plasma, or autoclaving. Samples were immersed in tryptone soya broth and thioglycollate medium and inspected for signs of microbial growth. Scaffold surface and mechanical and molecular weight properties were investigated. AlamarBlue viability assay of adipose derived stem cells (ADSC) seeded on scaffolds was performed to investigate metabolic activity. Confocal imaging of rhodamine phalloidin and DAPI stained ADSCs was performed to evaluate morphology. Ethylene oxide, gamma irradiation, argon plasma, autoclaving, 70% ethanol, and bleach were effective in sterilising the scaffolds. Autoclaving, gamma irradiation, and ethylene oxide led to a significant change in the molecular weight distribution of POSS-PCL and gamma irradiation and ethylene oxide to that of POSS-PCU (p<0.05). UV, ethanol, gamma irradiation, and ethylene oxide caused significant changes in the mechanical properties of POSS-PCL (p<0.05). Argon was associated with significantly higher surface wettability and ADSC metabolic activity (p<0.05). In this study, argon plasma was an effective sterilisation technique for both nonbiodegradable and biodegradable nanocomposite scaffolds. Argon plasma should be further investigated as a potential sterilisation technique for medical devices. [ABSTRACT FROM AUTHOR]

Background: The use of fat grafting as a reconstructive surgical option is becoming much more common. Adipose-derived stem cells found in fat grafts are believed to facilitate wound healing via differentiation into fibroblasts and keratinocytes and the release of pro-healing growth factors. Several small studies have shown a positive effect of fat grafting in healing of wounds of a variety of aetiologies. When fat is combined with autologous platelet-rich plasma (PRP), there may be enhanced healing effects. This may be due to the pro-angiogenic and anti-inflammatory effects of PRP. We aim to synthesise the current evidence on combination fat grafting and PRP for wound healing to establish the efficacy of this technique. Methods/design: We will conduct a comprehensive literature search in the MEDLINE, EMBASE, CENTRAL, Science Citation Index, and Google Scholar databases (up to July 2017) to identify studies on fat grafting and PRP for wound healing. All primary studies and systematic reviews of these studies will be included, except case reports and case series with fewer than three patients, to evaluate the outcome of fat grafting and PRP on wound healing either on its own or when compared to other studies. Primary outcome measures are expected to be the proportion of total wounds healed at 12 weeks and the average wound healing time (time for 100% re-epithelialisation). Expected secondary outcome measures are the proportion of wounds achieving 50% wound healing, the type of wound benefitting most from fat grafting, economic evaluation, health-related quality of life, and adverse events. Subgroup analysis will be performed for the proportions of wounds healed based on wound aetiology. Discussion: This review will provide robust evidence of the efficacy of fat grafting and PRP for wound healing. This is an emerging technique, and this review is expected to guide clinical practice and ongoing research aimed at improving wound care. [ABSTRACT FROM AUTHOR]

Vascularisation is often deemed the holy grail of tissue engineering because it is one of the key preconditions that determine the in vivo viability of tissue constructs. Given that a well-developed vascular network allows greater complexity in tissue design and helps regulate tissue metabolism, it appears that the overall outcome of engineered tissue implants depends on the success of microvessel formation, maturation and patterning. Current approaches to vascularising tissue include both in vivo and ex vivo techniques, where blood vessel formation is either spontaneous or guided by physical or biochemical factors. The success of these strategies can then be monitored and evaluated for clinical benefit through numerous standard and novel strategies. Despite the impressive progress in the field of tissue engineering in recent times, there are still numerous technical, immunological, surgical and ethical challenges to overcome. Future prospects in this field are likely to depend on the adoption of a wide-ranging approach incorporating a combination of salient themes such as genetic manipulation, modular assembly and bioreactor coupling. Where applicable, the potential contributions of nanobiotechnology to tissue vascularisation will be discussed as appropriate. [ABSTRACT FROM AUTHOR]

Background: The mainstay of autologous breast reconstruction involves abdominal wall-based tissue transfer in the form of free or pedicled TRAMs or more recently free DIEP flaps. Although excellent choices for breast reconstruction, all of these techniques do have significant morbidity when considering donor-site pain. This can lead to other complications such as reduced mobility, deep vein thrombosis, pulmonary emboli, respiratory infections, heavy opiate use, constipation and prolonged in hospital stay. Minimising postoperative donor-site pain is therefore of paramount importance. This article provides a review of the forms of analgesia available in the literature and in use in clinical practise. It is a summary of the published studies and exciting future options in this field. Methods: A literature search was performed through Medline, EMBASE, Cochrane database and Google Scholar for any previous research publications pertaining to postoperative analgesia in patients undergoing autologous breast reconstruction using abdominal tissue. We reviewed all articles with the aim to evaluate the current knowledge and evidence of analgesic techniques in autologous breast reconstruction including benefits, limitations, indications and patient outcomes. Results: The literature search yielded a total of 31 articles identifying 6 analgesic techniques: patient-controlled analgesia (PCA), epidural analgesia, continuous wound infusion with local anaesthetic, intermittent boluses of local anaesthetic, transverse abdominis plane (TAP) blocks and slow release bupivicaine. Conclusions: Various anaesthetic techniques are used to reduce postoperative mortality in autologous breast reconstruction. Knowledge of these techniques is paramount as it reduces complications and expedites discharge in this group of patients. Level of Evidence: Not ratable. [ABSTRACT FROM AUTHOR]