title: Evaluation of autologous platelet rich plasma for cardiac surgery: outcome analysis of 2000 patients.
abstract: BACKGROUND
  Deep and superficial sternal wound infections (DSWI & SWI) following cardiac surgery increase morbidity, mortality and cost. Autologous platelet rich plasma (PRP) derived from the patient's own blood has been used in other surgical settings to promote successful wound healing. The goal of this study was to analyze the addition of PRP using a rapid point of care bedside system to standard wound care in all patients undergoing sternotomy for cardiac surgical procedures.
  
  
  METHODS
  Over a 7 year period, 2000 patients undergoing open cardiac operations requiring sternotomy were enrolled. One thousand patients received standard of care sternal closure. The other 1000 patients received standard of care sternal closure plus PRP applied to the sternum at the time of closure. The outcomes related to wound healing, infection, readmissions, and costs were analyzed.
  
  
  RESULTS
  In the 2000 patients, there were more ventricular assist device implants/heart transplants and emergency operations in the PRP group; otherwise there were no significant differences. The use of PRP reduced the incidence of DSWI from 2.0 to 0.6 %, SWI from 8.0 to 2.0 %, and the readmission rate from 4.0 to 0.8 %. The use of PRP reduced the costs associated with the development of deep and superficial wound complications from $1,256,960 to $593,791.
  
  
  CONCLUSIONS
  The use of PRP decreases the incidence and costs of sternal wound complications following cardiac surgery. The routine use of platelet rich plasma should be considered for all patients undergoing sternotomy for cardiac surgical procedures.
  
  
  BACKGROUND
  Clinicaltrials.gov ( NCT00130377 ) for the data registry.
authors.affiliation: Division of Cardiothoracic Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA. Amit.Patel@hsc.utah.edu.
authors.forename: Amit N
authors.initials: AN
authors.lastname: Patel
authors.affiliation: Division of Cardiothoracic Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA.
authors.forename: Craig H
authors.initials: CH
authors.lastname: Selzman
authors.affiliation: Division of Cardiothoracic Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA.
authors.forename: Ganesh S
authors.initials: GS
authors.lastname: Kumpati
authors.affiliation: Division of Cardiothoracic Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA.
authors.forename: Stephen H
authors.initials: SH
authors.lastname: McKellar
authors.affiliation: Division of Cardiothoracic Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Bull
mesh_terms: D000368:Aged; D001804:Blood Transfusion, Autologous / Q000191:economics*; D006348:Cardiac Surgical Procedures; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D012189:Retrospective Studies; D056346:Sternotomy; D013530:Surgical Wound Infection / Q000191:economics / Q000401:mortality / Q000517:prevention & control*; D016896:Treatment Outcome; D014589:Utah; D014945:Wound Healing
keywords: Cardiac surgery; Infections; Platelets; Sternal; Wounds