Comparison of the effects of platelet-rich or growth factor-rich plasma on intestinal anastomosis healing in pigs

Abstract

BackgroundThe use of autologous platelet-rich plasma (PRP) and plasma rich in growth factors (PRGF) has been proposed for the treatment of several acute and chronic syndromes, such as corneal epithelial defects and dry eye syndrome, gum bleeding during oral surgery, and in orthopaedic surgery. We hypothesized that PRGF, rather than PRP, could be more effective because of its intrinsic characteristics in promoting the healing of intestinal anastomosis. The purpose of the present study was to evaluate and compare the effects of PRP and PRGF on various parameters of anastomotic healing in a swine model.MethodsEight female pigs were randomly assigned to two groups and subjected to hand sewn jeujuno-jejunal appositional extramucosal anastomoses. For each animal, a total of six anastomoses were performed: two were considered controls and received no treatment, while the remaining four anastomoses were treated with PRP or PRGF of which both were prepared at a platelet concentration that was respectively 3.4-fold and 2.81-fold higher than the original platelet count. In each animal, either PRP or PRGF was used as a treatment, to avoid interference among products. Animals were euthanized after 8 days and the anastomoses were evaluated and compared for the presence of adhesions, anastomotic leakage, bursting pressure, and histological appearance.ResultsThe concentration of platelets in PRP was 3.41-fold higher (range, 3.20–4.24) that the concentration in whole blood, while the concentration in PRGF was 2.81-fold higher (range, 2.89–4.88).The results obtained from the present study highlighted that there are no differences between anastomotic samples treated with either PRP or PRGF preparations, except for a significant increase in epithelization of the intestinal mucosa at the anastomotic site in the PRGF group.ConclusionsBoth PRP and PRGF suspensions should be considered a safe strategy and represent a relatively low-cost technology that is flexible enough to be applied in several therapeutic fields. No true benefit could be proven in our study compared to the no treatment following anastomoses formation, with the exception of enhanced epithelization of the mucosa in the PRGF group.Electronic supplementary materialThe online version of this article (doi:10.1186/s12917-017-1102-8) contains supplementary material, which is available to authorized users.

Platelet-rich autoplazma effect on intestinal anastomosis regeneration in rabbits

“…it is important to understand that our knowledge in the area of molecular secretion mechanisms, genetic regulation, and PRP-therapy effects on the regeneration processes is still limited (10). according to available literature, there have been several studies into the PRP effect on intestinal anastomosis regeneration comparing compared prp soaking in the intestinal walls with prp injection in anastomosis walls (13,14). our analysis of the histological and morphometric data also illustrated that regeneration between the intestinal anastomosis sites treated by prp soaking and prp injection into the intestinal wall (table 2) was more favorable in comparison with the control group, which was determined by the quantitative correlation between the inflammatory infiltrate, proliferation of fibroblasts, neoangiogenesis, and collagen deposition (table 4).…”

“…platelet-rich plasma became widely used in clinical practice because a high concentration of growth factors should promote better tissue regeneration (4,13,17). Despite a large number of studies devoted to PRP effect on intestinal anastomosis regeneration, still, the impact of autoplasma on adhesion and different methods of PRP application is not well established (5,9).…”

“…Despite a large number of studies devoted to PRP effect on intestinal anastomosis regeneration, still, the impact of autoplasma on adhesion and different methods of PRP application is not well established (5,9). as a rule, soaking the intestinal walls with prp precedes the anastomosis formation (13,14), although injected PRP, which proved to be highly effective in other areas of medicine (17,18,19,20), has not been applied to the intestinal anastomosis.…”

“…Many experimental studies dealing with the strength of the formed intestinal anastomoses define wound-bursting strength at an increased intestinal pressure (5,9,13,14). We believe the anastomosis regeneration indicators should be extend-ed to measuring the intestinal anastomosis strength with morphometric indicators (21,22).…”

Anti‐Adhesive, Platelet Gathering Effects of c‐RGD Modified Poly(p‐dioxanone‐co‐l‐Phe) Electrospun Membrane and Its Comprehensive Application in Intestinal Anastomosis

“…Platelets play crucial roles, not only in hemostasis, but in the anastomotic stoma healing process . Platelets secrete several growth factors and cytokines which initiate or participate in the healing process . Hence, autologous platelet rich plasma, fibrin, or gel has been applied in clinical settings to improve the healing of various kinds of wounds .…”