Eric Lullove, DPM, Discusses Autologous Platelet Rich Plasma

In this video, Eric Lullove, DPM, discusses autologous platelet-rich plasma and how the process can be used in the field of wound care.

Eric Lullove, DPM, is the Chief Medical Officer at the West Boka Medical Center for Wound Healing and is a podiatrist in private practice in Coconut Creek, Florida. 

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Transcript:
Hi, this is Dr. Eric Lullove. I'm the Chief Medical Officer of the West Boca Center for Wound Healing. I'm a podiatrist in private practice in Coconut Creek, Florida.

So one of the newer technologies that we've been looking at over the last six months to a year has been this newfound autologous platelet, whole blood clotting that we've been able to draw off the patient and use on wounds. A couple companies have products out there for this. It's the use of basically drawing off the patient's blood and either placing into a tray where it's clotted, or it's drawing off the patient's blood and placed into a centrifuge through a very specialized process, which then creates a patch.

So both technologies are kind of newer in this regenerative medicine type space where we've gone from placental amniochorionic to synthetic type collagens, kind of manufactured collagens, and we've gone to other xenografts where we've been using fish and other animals. Over years, we've used bovine. We've used pig. I think there was a horse equine at one point. We've had bladder, your bovine bladder and porcine bladder. So we've used... Oh, and sheep. I'm sorry. We've used it. We've had sheep too. Yes. We have sheep skin and sheep stomach actually.

So we've used all the xenograft material and we've moved from xenografts to amnios, to chorionic, to mixture products, to synthetic collagens. And now the next thing that we've been moving to is going back to autologous. The technology's gotten so much better in not just drawing off the patient's blood of venous blood, but then utilizing the core components to create a tissue product, which is either a platelet-rich fibrin patch, or a whole blood clot that's applied directly to most cases, diabetic foot ulcers.

The idea is that you're using the patient's own growth factors. So you're not putting anything exogenous into the mixture and into what's being formed. The patient's allowed to use their own body to heal their wound exogenously. Of course, there's always going to be a drawback. If the patient has really poor protoplasm, does not have a great healing potential interiorly, they're chronic inflamed, the platelets may not be as active activated because of the macrophage response. They could just be inhibitory.

So it's always one of these things that anytime you are going to apply an autologous patient or autologous product, you have to assess the patient. Patients in active RA or active lupus, they don't have any ability of making macrophage responses. So you're not going to get the same response in the blood. It's going to be like, basically throwing plasma on that's not going to have any anti-inflammatory, in fact, to reduce wound inflammation.

So again, all these products are utilized just like you would any other tool. It's another thing in the shelf. It's another thing in the drawer that we use in the arsenal to help treat the patient. At the end of the day, you still got to use what you know up here and apply it to what you're seeing down there. And hopefully as we get more technology, we'll be able to maybe have some different hybrid dressings, smart dressings, nanotechnology might come into the place in the next 10 to 15 years, provide the FDA can get through the process. And we'll see where things go.

But all I know is that technology in our industry is here to stay and it's progressing much rapidly than we thought it would be. The old days of just doing dressing therapy, it's not there anymore. You have to... The whole industry's moving toward advanced therapy. Because we know that based on the empiric data, that the earlier you intervene with advanced therapy, the faster the patients are able to close and they can get back to their normal quality of life. And that's all that we ever really want for them.