Effects of autologous platelet-rich plasma coated sutures on intestinal anastomotic healing in rabbits

Daradka, Mousa; Alardah, Mira M.; Ismail, Zuhair Bani

doi:10.1016/j.heliyon.2019.e02713

Cited by 8 publications

(10 citation statements)

References 49 publications

(65 reference statements)

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“…In a study by Daradka et al including anastomosis applied in rabbit bowel with a suture material similar to that we used, the suture was first treated with 70% ethanol, kept in PRP containing 6 ± 1:3 × 10 8 /microL platelets gelled with sodium acetate for 30 minutes to provide covering of the suture; the suture was then dried in the room air and used in the anastomosis. In that study, when the suture covered with PRP gel was compared with uncovered suture or the suture covered only with sodium citrate, a significant increase was found in tissue hydroxyproline levels and anastomotic bursting pressure [25]. Although the results of that study were consistent with our results, in our technique, much shorter time is needed to cover the suture and the effectiveness of PRP at different concentrations was compared.…”

Section: Gastroenterology Research and Practicesupporting

confidence: 81%

Comparison of Platelet-Rich Plasma-Impregnated Suture Material with Low and High Platelet Concentration to Improve Colonic Anastomotic Wound Healing in Rats

Aydın

Güler

Demiröz

et al. 2020

Gastroenterology Research and Practice

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Objective. This study was designed to investigate the impact of using suture material impregnated with platelet-rich plasma (PRP) in different platelet concentrations on colonic anastomotic wound healing in rats. Methods. A total of 24 Sprague Dawley female rats were separated into 3 groups (n=8 for each) including the control group (CON; standard vicryl suture repair), the low platelet concentrate PRP group (L-PRP; suture material impregnated with PRP containing average 2.7-fold (range, 2.0 to 3.1) higher amount of platelets vs. control), and the high platelet concentrate PRP group (H-PRP; suture material impregnated with PRP containing average 5.1-fold (range, 4.8 to 5.4) higher amount of platelets vs. control). Rats were sacrificed on the postoperative 7th day for analysis of colonic anastomosis region including macroscopic observation, measurement of anastomotic bursting pressure (ABP), and the hydroxyproline levels and histopathological findings in colon tissue samples. Results. Total injury scores were significantly lower in the L-PRP and H-PRP groups than those in the control group (median (range) 13.00 (7.00) and 11.50 (6.00) vs. 15.50 (4.00), p<0.05 and p<0.01, respectively). ABP values (180.00 (49.00) vs. 124.00 (62.00) and 121.00 (57.00) mmHg, p<0.001 for each) and tissue hydroxyproline levels (0.56 (0.37) vs. 0.25 (0.17) and 0.39 (0.10) μg/mg tissue, p<0.001 and p<0.05, respectively) were significantly higher in the L-PRP group as compared with those in the control and H-PRP groups. Conclusion. In conclusion, our findings revealed PRP application to colonic anastomosis sutures to promote the anastomotic healing process. The platelet concentration of PRP seems to have a significant impact on the outcome with superior efficacy of L-PRP over H-PRP in terms of bursting pressures and collagen concentration at the anastomotic site.

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Section: Gastroenterology Research and Practicesupporting

confidence: 81%

Comparison of Platelet-Rich Plasma-Impregnated Suture Material with Low and High Platelet Concentration to Improve Colonic Anastomotic Wound Healing in Rats

Aydın

Güler

Demiröz

et al. 2020

Gastroenterology Research and Practice

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“…The majority of the studies (12 studies) investigated the effect of PRP on colonic anastomosis, while six studies investigated the effect on small bowel anastomosis[ 16 , 18 , 19 , 25 , 27 ]. End-to-end anastomosis was performed to restore the bowel continuity in all included studies.…”

Section: Resultsmentioning

confidence: 99%

“…The origin of PRP was homologous or autologous. Autologous PRP was used in three rat studies[ 9 , 10 , 34 ], two rabbit studies[ 25 , 27 ] and three pig studies[ 19 , 26 , 28 ]. Daglioglu et al [ 9 ] and Özçay et al [ 16 ], in the autologous PRP group, extracted 2.5 mL and 1 mL from each rat, respectively, while Yol et al [ 10 ] did not report the amount of blood taken from each rat.…”

Section: Resultsmentioning

confidence: 99%

“…Direct application of PRP on bowel anastomosis was mentioned in 13 studies[ 9 , 10 , 16 , 18 , 26 , 29 - 36 ], merging of the bowel edges with PRP enriched material in three studies[ 19 , 25 , 28 ], PRP injection adjacent to anastomosis in one study[ 25 ], and anastomosis performed with PRP coated sutures in two studies[ 17 , 27 ]. Lastly, two studies investigated PRP pharmacokinetics[ 18 , 27 ]. PDGF subunit A release to the media from PRP coated sutures was stable and showed no significant changes at 1, 2, 24 and 48 h post application.…”

Section: Resultsmentioning

confidence: 99%

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Platelet rich plasma effectiveness in bowel anastomoses: A systematic review

Geropoulos¹,

Psarras²,

Giannis³

et al. 2021

WJGS

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BACKGROUND Anastomotic leak constitutes a major problem in abdominal surgery. Technical insufficiency, topical or systemic factors contribute to disrupted healing of the performed bowel anastomosis and result in anastomosis leakage, with detrimental effects on patient postoperative outcomes. Despite the investigation of several factors and the invention of protective materials, the ideal agent to prevent anastomotic leaks is yet to be determined. AIM To study the effect of platelet rich plasma (PRP) on the healing of bowel anastomoses. METHODS A systematic literature search was performed in PubMed, EMBASE, and Scopus databases to identify studies investigating the effect of PRP application on bowel anastomosis. RESULTS Eighteen studies were eligible with a total population of 712 animals including rats (14 studies), rabbits (2 studies) and pigs (2 studies). No postoperative complications were reported following PRP application. Fourteen out of 18 studies reported a statistically significant higher anastomosis bursting pressure in PRP groups compared to control either in healthy animals or animal models with underlying condition or intervention, such as intraperitoneal chemotherapy or peritonitis. Similar results were reported by ten studies in terms of tissue hydroxyproline levels. One study reported significant increase in collagen deposition in PRP groups. PRP application resulted in significantly decreased inflammatory cell infiltration in the presence of peritonitis or intraperitoneal chemotherapy (6 studies). CONCLUSION The application of PRP is associated with improved bowel anastomosis outcomes, especially in animal models having an underlying condition affecting the normal healing process. PRP application seems to augment the normal healing process under these circumstances. However, further studies are needed to investigate the potential role of PRP on bowel anastomosis healing, especially in clinical settings.

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“…Muraoka et al [ 83 ] added growth factors such as myostatin. Other authors have tested sutures solely impregnated by platelet-rich plasma[ 84 , 85 ] or VEGF[ 86 ] with interesting results. Therefore, more studies on biosuture preparation and potential adjuvants are needed.…”

Section: Discusionmentioning

confidence: 99%

Stem cell therapy applied for digestive anastomosis: Current state and future perspectives

Trébol¹,

Georgiev-Hristov²,

Migueláñez³

et al. 2022

WJSC

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BACKGROUND Digestive tract resections are usually followed by an anastomosis. Anastomotic leakage, normally due to failed healing, is the most feared complication in digestive surgery because it is associated with high morbidity and mortality. Despite technical and technological advances and focused research, its rates have remained almost unchanged the last decades. In the last two decades, stem cells (SCs) have been shown to enhance healing in animal and human studies; hence, SCs have emerged since 2008 as an alternative to improve anastomoses outcomes. AIM To summarise the published knowledge of SC utilisation as a preventative tool for hollow digestive viscera anastomotic or suture leaks. METHODS PubMed, Science Direct, Scopus and Cochrane searches were performed using the key words “anastomosis”, “colorectal/colonic anastomoses”, “anastomotic leak”, “stem cells”, “progenitor cells”, “cellular therapy” and “cell therapy” in order to identify relevant articles published in English and Spanish during the years of 2000 to 2021. Studies employing SCs, performing digestive anastomoses in hollow viscera or digestive perforation sutures and monitoring healing were finally included. Reference lists from the selected articles were reviewed to identify additional pertinent articles. Given the great variability in the study designs, anastomotic models, interventions (SCs, doses and vehicles) and outcome measures, performing a reliable meta-analysis was considered impossible, so we present the studies, their results and limitations. RESULTS Eighteen preclinical studies and three review papers were identified; no clinical studies have been published and there are no registered clinical trials. Experimental studies, mainly in rat and porcine models and occasionally in very adverse conditions such as ischaemia or colitis, have been demonstrated SCs as safe and have shown some encouraging morphological, functional and even clinical results. Mesenchymal SCs are mostly employed, and delivery routes are mainly local injections and cell sheets followed by biosutures (sutures coated by SCs) or purely topical. As potential weaknesses, animal models need to be improved to make them more comparable and equivalent to clinical practice, and the SC isolation processes need to be standardised. There is notable heterogeneity in the studies, making them difficult to compare. Further investigations are needed to establish the indications, the administration system, potential adjuvants, the final efficacy and to confirm safety and exclude definitively oncological concerns. CONCLUSION The future role of SC therapy to induce healing processes in digestive anastomoses/sutures still needs to be determined and seems to be currently far from clinical use.

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Effects of autologous platelet-rich plasma coated sutures on intestinal anastomotic healing in rabbits

Cited by 8 publications

References 49 publications

Comparison of Platelet-Rich Plasma-Impregnated Suture Material with Low and High Platelet Concentration to Improve Colonic Anastomotic Wound Healing in Rats

Comparison of Platelet-Rich Plasma-Impregnated Suture Material with Low and High Platelet Concentration to Improve Colonic Anastomotic Wound Healing in Rats

Platelet rich plasma effectiveness in bowel anastomoses: A systematic review

Stem cell therapy applied for digestive anastomosis: Current state and future perspectives

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