Apprising the diverse facets of Platelet rich fibrin in surgery through a systematic review

Context: Comprehensive reviews on clinical applications of Platelet rich fibrin (PRF) in surgery are limited despite its extensive utilization resulting in a dearth of knowledge on its effectiveness. Hence this article focuses on shedding light to the various applications of PRF pertaining to surgery through a systematic review. Objective: The systematic review is aimed at evaluating the value of PRF in different areas of surgery. Data sources: A systematic review of articles sourced from MEDLINE-pubmed (2008-2017(July)) was done. Additional articles were searched through GOOGLE SCHOLAR and SCIENCE DIRECT. Search terms such as Platelet rich fibrin; Platelet rich fibrin, surgery; Platelet concentrate; second generation concentrate; Applications of PRF in surgery were used. Study selection: Systematic reviews, Randomized control trials, Pilot studies and Case reports were included. Non English articles, in-vitro and animal studies were excluded. Data extraction: Independent sourcing of articles by 3 authors using a set of predefined criteria. Data synthesis: Out of the 25 articles covering various surgical procedures that met the inclusion criteria, positive outcomes were noted in most. Although categorization into one specific type of study was not done, the overall success rate with PRF usage was 78%. No differences between test and control groups were observed in 2 studies and 3 studies showed no significant improvements with the usage of PRF. Limitations: The systematic review did not categorize the study designs while evaluating success rates which might be considered as a shortcoming as case reports were also included. Conclusions: The future propositions are vast and point towards innovative applications of this biomaterial possibly in transplant and burn cases if a method of obtaining large amounts can be devised. However since we rely on evidence-based results, further long term studies are needed in distinct areas of applications to decisively prove its effectiveness. (C) 2017 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.