Application of Platelet Rich Plasma in Experimental Colonic Anastomosis for Improved Strength

Yali, Ali Can; Eren, Saliha Karagöz; Ertan, Tamer; Topuz, Ömer

doi:10.1007/s12262-020-02400-x

Cited by 1 publication

(5 citation statements)

References 11 publications

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“…In the pig and rabbit groups, a total of 60-100 mL and 8-10 was taken, respectively. All ten studies that investigated the effect of homologous PRP were conducted on rats[ 17 , 18 , 29 - 36 ] and the number of rat donors ranged from five to twelve rats, while the amount of blood drawn from each donor ranged between 5-10 mL. A two-step centrifugation technique was applied in 16 studies investigating PRP.…”

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 ].…”

Section: Resultsmentioning

confidence: 99%

“…In contrast, Fresno et al [ 19 ] reported that on postoperative day 7 the PRP treated anastomosis developed increased, but not significantly different, mature granulation tissue and fibrosis. Yalı et al [ 36 ] findings were significant for higher vascularization, fibroblast organization and epithelial formation in the PRP treated peritonitis model. Pehlivanli et al [ 33 ] compared several agents and concluded that PRP application was associated with better re-epithelialization scores compared to Zeolite application and control groups.…”

Section: Resultsmentioning

confidence: 99%

“…Although 50% (9/18) of the included studies reported no statistically significant changes in the anastomosis bursting pressure in PRP-treated compared to control groups, five studies reported that the application of PRP in the presence of an underlying medical or surgical condition, improved the anastomosis bursting pressure. Furthermore, the application of PRP in the open abdomen, ischemic /reperfusion injury, peritonitis, intraperitoneal 5-fluorouracil (5-FU) infusion, and hyperthermic intraperitoneal chemotherapy with 5-FU animal models was associated with statistically significant improved anastomosis bursting pressure[ 16 , 29 , 30 , 32 , 36 ]. Among, the other four studies, Dauser et al [ 26 ] investigated the application of PRF, which presents some component differences compared to PRP.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, anastomotic wound inflammatory cellular infiltration in control compared to PRP groups did not show any statistically significant changes among the included studies. However, it was reported that in the presence of an underlying detrimental condition like intraperitoneal chemotherapy or infection, PRP application significantly decreased the inflammatory cellular infiltration in bowel anastomosis[ 30 - 32 , 34 - 36 ]. Theoretically, enhanced anastomosis strength associated with PRP application could partially be attributed to decreased inflammatory cell-mediated collagen degradation[ 42 ].…”

Section: Discussionmentioning

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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