Complex Biostimulation of Intrapleural Adhesiogenesis in Thoracal Surgery

Abstract

The aim of the study is to determine the effectiveness of the use of platelet enriched plasma in the complex treatment of chest trauma and chronic pleural empyema.Materials and methods. The work was performed on 450 male rats, simulated with chest trauma (n=180) and chronic pleural empyema (n=270). In the experimental groups, biostimulation of adhesiogenesis as an intrapleural injection of 1 ml of platelet-enriched plasma was carried out; in the comparison group; the animals with pleural empyema were injected with 1 ml of doxycycline solution; in the negative control groups, the treatment was not carried out at all. Withdrawal from the experiment took place on the 10th, 20th, 30th days. The samples of intrapleural adhesions were fixed in 10% formalin, followed by histological tracing and preparation of micropreparations, staining with hematoxylin and eosin. The morphometric study included determination of the volume fraction (VF) of collagen and reticular fibers; fibrin; inflammatory cells; blood-stream (%).Results. An intrapleural administration of platelet-rich plasma is an effective way to stabilize the rib cage in chest injuries, and to eliminate residual cavities in chronic pleural empyema. When assessing the severity of the adhesions in chest trauma, it was found out that adhesions are most often visualized at the sites of rib fractures (from 13.3 to 40%). In pleural empyema, during the entire process of observation, the VF of collagen fibers forming adhesions was higher in the group with biological stimulation of adhesiogenesis than in the NCpe group and in the CG. In the PRP group, already at the initial stages of the experiment, this indicator was significantly lower than in the NC and CG (p<0.05).Conclusion. Based on the data obtained, the effectiveness of the use of platelet-enriched plasma in thoracic surgery for the biological potentiation of adhesiogenesis has been proved in experimental chest injuries and chronic pleural empyema.