The Effect of Warfarin on the Fibrin Architecture of Platelet-Rich Fibrin

Abstract

© 2019 Mutaz B. Habal, MD. Aim: The aim of the study was to compare the macroscopic and microscopic factors, using scanning electron microscopy (SEM), of platelet-rich fibrin (PRF) between patients taking warfarin and healthy volunteers. Materials and methods: Twenty participants were selected (55 years old or older). Ten patients undertaking warfarin therapy with an International Normalized Ratio (INR) range from 2.50 to 4.00 acted as an experimental group and 10 healthy volunteers acted as a control group. Twenty-five-milliliter blood samples were collected from the 20 patients for PRF production and laboratory screening (INR and hematocrit). Then, PRF clots were compressed to a 1- millimeter membrane. All PRF sample macroscopic features (color, length, and width) were recorded and prepared for SEM evaluation. Images were obtained with SEM with 8000 times magnification. The percentage of the fibrin density was measured using ImageJ software (NIH, Bethesda, MD). Descriptive analysis was used to describe the macroscopic features. An independent t test and 1-way analysis of variance were used to compare both groups and each segment of PRF. Results: All macroscopic features were totally identical. The fibrin density average from the upper to lower end was 89.09%-1.99%, 88.11%-3.25%, and 88.61%-2.65% (control group) and 88.62%-1.53%, 88.62%-1.20%, and 89.54%-2.17% (experimental group), respectively. There were no significant differences in the macroscopic features between the 2 groups and no differences in the microscopic features between the 2 groups and within each group. Conclusions: Warfarin did not have an effect on PRF when the macroscopic and microscopic features were compared between healthy volunteers and warfarin therapy volunteers.