Effectiveness of Pre PRP Injection and Post Elevation Flap at Extended Random Flap Rat Skin

Abstract

Closure of the defect with a random skin flap is constrained by the extent of the defect area. Several studies have shown the benefits of administration of PRP (Platelet Rich Plasma) in random skin flap. The purpose of this study is to compare the effect of PRP injection given before flap elevation, after flap elevation and control on the extended random skin flap procedures in rats. This was an experimental study with randomized posttest-only control group design (n=27, divided into 3 treatment groups) that compare the effectiveness of PRP injection 24 hours prior to the elevation of the flap, after the elevation of the flap, and control in the extended random skin flap in rats. Random skin flap is made in the ratio 1: 5 on the rat skin. Measurement of viable area were observed on days 1, 7 and 14. There were significantly increased viability of random skin flap on the group with PRP injection 24 hours prior flap elevation compared to other group of treatment. The average of viability on day first 39%±13% ;42%±34%; 62%±14%. On day 7th 24%±13%; 36%±26%; 62%±12%. On day 14th 16%±15%; 28%±22%; 60%±11%. Injection of PRP on extended random skin flap on rat 24 hours before flap elevation increase viability of the flap compared to control group and group which receive PRP injection on extended random flap on rat skin after elevation of the flap. Viability increased due to angiogenesis stimulation after PRP injection.

Preconditioning Local Injection of Activated Platelet-Rich Plasma Increases Angiogenesis, VEGF Levels, and Viability of Modified McFarlane Flap in Diabetes-Induced Rats

“…25 In a recent study, Nugroho et al demonstrated that local administration of PRP injection 24 hours prior to random skin flap elevation procedure increased flap viability in Wistar rats. 10 Our findings align with this previous research, indicating that flap preconditioning with subcutaneous injection of PRP 1 day prior to flap procedure increased flap survival by 20.1% compared with those without PRP, even under diabetic conditions. Previous research by Qian et al has also confirmed the effects of PRP in augmenting collagen production and promoting tissue regeneration in diabetic rats.…”

“…Similar phenomenon have been observed in previous studies utilizing PRP to aid in skin defect closure. (10,11) Immediately after random skin flap elevation, perfusion pressure of the flap decreases, which then increases the risk of distal flap necrosis. Ischemia-reperfusion injury exacerbates the insult to flap survival due to elevated reactive oxygen species and the inflammatory cascade, leading to vasoconstriction, platelet aggregation, and vessel occlusion(12).…”