Platelet-rich plasma reduces skin flap inflammatory cells infiltration and improves survival rates through induction of angiogenesis: An experiment in rabbits

J Plast Surg Hand Surg. 2016 Aug;50(4):239-45. doi: 10.3109/2000656X.2016.1159216. Epub 2016 Mar 24.

Abstract

Background: This study was conducted to evaluate the effects of platelet-rich plasma (PRP) on flap survival in an experimental rabbit model.

Methods: Symmetrical rectangular dorsal cutaneous flaps (8 × 2 cm) were elevated in 15 rabbits. The rabbits were randomly divided into a 3-day group (n = 5), a 7-day group (n = 5), and a 14-day group (n = 5). Either side of the dorsum was selected for injection of PRP into the flap basal surface, while the other side received an equal volume of saline as a control. The flaps were immediately sutured back, after which the flap survival was measured and histology specimens were collected at 3, 7, and 14 days.

Results: Platelet-rich plasma significantly improved flap survival rates of the PRP side flaps relative to the control in the 3-day (74.4% ± 4.7% vs 65.8% ± 6.8%; p < 0.05), 7-day (72.4% ± 7.5% vs 58.5% ± 7.0%; p < 0.05), and 14-day (74.5% ± 5.0% vs 65.0% ± 5.4%; p < 0.05) groups. Histological analysis revealed significantly fewer inflammatory cells and an increased blood vessel density in the platelet-rich plasma side flap vs the blank control side flap.

Conclusion: Platelet-rich plasma (PRP) promotes the survival of random rabbit flaps and, therefore, represents a promising treatment to prevent skin flap necrosis in reconstructive and plastic surgery.

Keywords: Platelet-rich plasma; neovascularisation; skin flap; survival rate.

MeSH terms

  • Animals
  • Antigens, CD34 / analysis
  • Graft Survival*
  • Immunohistochemistry
  • Inflammation / pathology
  • Male
  • Models, Animal
  • Neovascularization, Physiologic*
  • Platelet-Rich Plasma*
  • Rabbits
  • Random Allocation
  • Skin Transplantation
  • Surgical Flaps / blood supply*
  • Surgical Flaps / pathology
  • Vascular Endothelial Growth Factor A / analysis

Substances

  • Antigens, CD34
  • Vascular Endothelial Growth Factor A