ACHILLES TENDINOPATHY PROTOCOL

The benefits seen from the use of prp in vaginal tissues come from the angiogenesis and renewed collagen fibers that grow. Women report improvement in sensation in the g-spot area and clitoris. Patients also describe a reduction in their urinary incontinence symptoms. Therefore, the best candidates are women who have decreased sensation, those desiring enhanced sensation or women who experience urinary stress incontinence. The quality of the skin shows improvement as well. Therefore, epithelial abnormalities such as lichen sclerosis should consider prp treatment.

A double spin, closed processing system that is able to concentrate the platelets to 6-8%.

Materials Needed:

• Topical numbing cream: Benzocaine 20%, Lidocaine 8%, or Tetracaine 8%, compounded.
• 5cc Syringes
• 27 gauge half inch needles
• Calcium Chloride
• Ice packs
• Alcohol based cleaner

Also, have patient purchase a penile pump before day of procedure.

Please carefully read and have your patient follow these instructions prior to their PRP treatment.

The patients must be advised to:

AVOID: Aspirin, Motrin, ibuprofen, Aleve (all non-steroidal and steroidal anti-inflammatory agents), curcumin, turmeric, Gingko biloba, garlic, flax oil, cod liver oil, vitamin A, vitamin E, or any other essential fatty acids at least 1 week prior to and after treatment. This includes pain gels such as Voltaren and Salonpas, etc. for pain relief.

Remember, we are creating inflammation.

Screen patients for systemic steroids such as; Prednisone, Hydrocortisone, etc. for at least 2 weeks prior to procedure. This includes (epidurals and other steroid injections).

Please advise the patients to avoid vigorous exercise, sun, and heat exposure for at least 3 days prior to treatment.

They should also avoid alcohol, and cigarettes for 3 days before and after treatment.

The hardest part of the procedure maybe to draw blood! So, increase fluid intake.

DIET AND FLUID INTAKE:  Please increase intake of fluid the day before  procedure by drinking 2 glasses of water in the morning before PRP session, 2 glasses at lunch and 2 glasses at dinner.

Advise eating a normal breakfast or lunch the day of your PRP session. Do not eat for 3 hours prior to procedure. They should take routine morning medications as long as they are not anti-inflammatory, or blood thinners. Please see list above.

The patient should have a recent gyn exam and normal Pap smear. Also, no active vaginal infections.

Please visit www.osot.com for certified training.

Please carefully read and have your patient follow these instructions after their PRP treatment. There are minimal restrictions after PRP injections allowing the patient to return to daily activities almost immediately.

The patient should NOT touch, press, rub or manipulate the treated area(s) for at least 12 hours after the treatment.

AVOID: Aspirin, Motrin, ibuprofen, Aleve (all non-steroidal and steroidal anti-inflammatory agents), curcumin, turmeric, Gingko biloba, garlic, flax oil, cod liver oil, vitamin A, vitamin E, or any other essential fatty acids at least 1 week prior to and after their treatment. Remember, we are creating inflammation, so any drugs or foods that have anti-inflammatory properties must be avoided, including pain gels such as Voltaren and Salonpas, etc.

If the patient experiences discomfort or pain, they may take Tylenol or other acetaminophen products.

Heat may be applied, to the injected area for 20-30 minutes after the procedure, but it would preferable if they can refrain from this. Ice or cold packs should never be applied to the treated area!

The patient should not wash or take a shower for at least 6 hours after their treatment.

They should not use any lotions, creams, or make-up for at least 6 hours after their treatment.

AVOID: Vigorous exercise, sun, and heat exposure for at least 3 days after your treatment.

AVOID: Alcohol, caffeine, and cigarettes for 3 days before and after your treatment.

Smokers do not heal well, problems recur earlier, and results may take longer.

Patients should drink plenty of water for 2 weeks (10 cups per day).

They can return to physical therapy 7 days after treatment.

They may return to the gym 10 days after treatment.

It is normal to experience: bruising, redness, itching, soreness, and swelling that may last from 3-10 days following their procedure. Important reminder: There should be no fever or purulent discharge (pus) from the site. If there is, have the patient contact you immediately.