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Amnion Versus Platelet Therapy for Healing

The Role of Injectable and Bandage Stimulants

There are some times when an injectable stimulant could mean liquid stem cells or the product of liquid stem cells. We call the exosomes placed on the inside of the body through an injection. That is superior to a bandage type stimulant like amnion. So the anatomy is of course important.
But in addition to that we have to decide whether or not the patient is capable of responding to the stimulant. Of course prior to applying any stimulant we need to make sure that the foundational systems are in place.
The most obvious that everyone will think of is the circulatory component. If there is no blood going to the area well that must be re established first. Otherwise no matter how many stimulants you put on the wound the patient will not respond.
The nutritional status we have mentioned numerous times and that needs to be in place also. Because if the bricklayer is present but there are no bricks you cannot rebuild a wound.

What I Consider When Choosing Between Them

Once we get through with those prerequisites and we are ready to choose a stimulant the anatomy is very important. The concentration and number of growth factors is also an extremely important consideration at least by me.
That is where the question of platelet rich plasma versus something like amnion comes into play.
Think about this. If we draw tissue in this case platelets from a sick patient it could be said by extension that we are drawing sick platelets and expecting them to behave like strong platelets.
What do I mean by that. A sick patient a person with diabetes poor metabolism they may not have good energy production. They may not have good nutrition. They may not have good protein synthesis within all of their cells including their platelets.
By contrast an amniotic tissue that comes from a new mother who is completely healthy and its function is simply to make a baby grow you can have confidence that the power and number of growth factors in that tissue is going to be far superior.
Usually I will never opt for platelets when I can have amnion or I will never opt for platelets when I can have exosomes from the umbilicus of live births because they are young healthy active and plentiful in the area of enzymes and messenger RNA.

PRP Is Still Used but Not My First Choice

Now there are times when the finances get involved because these allografts these donated tissues the exosomes the stem cells the amnion those are the donated tissues. They can be quite expensive and sometimes we have no alternative but to use platelet rich plasma.
However as far as I am concerned platelet rich plasma is yesterday's technology. Still commonly used but not nearly as effective as some of these others that I have mentioned.
So that is how it goes.

Written by Dr. John Marzano

Board-certified podiatric surgeon with 35+ years of experience in wound care