Platelet-Rich Fibrin, Preparation and Use in Dermatology

The goal of these recommendations is to provide a framework to practitioners for implementing useful, evidence-based recommendations for the preparation of platelet-rich fibrin (PRF) and its use in various dermatological indications. The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) assigned the task of preparing these recommendations to its taskforce on platelet-rich plasma. A comprehensive literature search was done in the English language on the PRF across multiple databases. The grade of evidence and strength of recommendation was evaluated on the GRADE framework (Grading of Recommendation, Assessment, Development and Evaluation). A draft of clinical recommendations was developed on the best available evidence which was also scrutinized and critically evaluated by the IADVL Academy of Dermatology. Based on the inputs received, this final consensus statement was prepared. A total of 40 articles (meta-analyses, prospective and retrospective studies, reviews [including chapters in books] and case series) were critically evaluated and the evidence thus gathered was used in the preparation of these recommendations. This expert group recommends use of A-PRF+ protocol, that is (200 g for 8 min) for preparation of solid PRF and C-PRF protocol (700 g for 8 min) for liquid PRF. Swing out bucket model of centrifuge or the horizontal centrifuge is recommended for preparation of both PRF, and liquid PRF. Centrifugation must begin within 90-120 s of drawing of blood. PRF can be used in various indications for skin rejuvenation and nonhealing ulcers as either monotherapy or in combination with other therapies.