Adapted from Giannini et al. 2015
The L-PRF cloth is obtained without any manipulation of the blood: this method, therefore, totally respects the European directive 2004/23/EC, while PRP requires the addition of biochemical additives.
After centrifugation, the L-PRF cloth obtained contains:
One of the main difference between the L-PRF concept and most PRPs systems is that L-PRF production process is completely natural, with no use of anticoagulant during blood harvest nor bovine thrombin and calcium chloride for platelet activation and fibrin polymerisation.
L-PRF therefore is often simply considered as a natural optimised blood clot (Dohan Ehrenfest et al. 2010).
Preparation of PRP vs. L-PRF
Figure 1 gives a short overview of the preparation of L-PRF (A) and L-PRP (B). Immediately it becomes obvious that the preparation of L-PRF is extremely simple, that no additives are used and that it basically represents a selection of the most valuable components of the blood of the patient. The preparation of L-PRP is more complex and a diversity of protocols have been proposed, which might explain the inconsequent observations reported in the literature due to mistakes/shortcoming in the procedure. The simplicity of production of L-PRF leads to a reduced possibility of alteration of the protocol due to an error of the operator.
Figure 2 shows the tube (a) after centrifugation (with a separation between PPP (better called supernatant or serum), platelet poor plasma, the L-PRF cloth, and the red blood cells. After gentle compression, a strong membrane is obtained (b).
Nowadays, the only FDA-approved CE-marked system of L-PRF with certified materials is marketed under the name IntraSpin L-PRF (Intra-Lock Inc., Boca Raton, FL, USA).