Effect of platelet-rich plasma on polypropylene meshes implanted in the rabbit vagina: histological analysis

Abstract

Purpose The polypropylene mesh (PPM) is used in many surgical interventions because of its good incorporation and accessibility. However, potential mesh-related complications are common. Platelet-rich plasma (PRP) improves the healing of wounds and is inexpensive. Thus, the purpose of this study was to analyze the effect of the PRP-gel coating of a PPM on inflammation, production of collagen, and smooth muscle in the rabbit vagina.Materials and Methods The intervention consisted of a 1.5cm incision and divulsion of the vaginal mucosa for the implantation of a PRP-coated PPM. The PRP-coated mesh was implanted in 15 rabbits, and in the second group, the same implant was used without the PRP coating. In the sham group, the intervention consisted of the incision, divulsion, and suture. The rabbits were euthanized at 7, 30 and 90 days, and full-thickness sagittal sections of the posterior vaginal wall and rectum were scored. The inflammatory infiltrate was evaluated using hematoxylin and eosin staining. The Sirius Red stain was used to examine deposition of collagen I and III, and Masson’s trichrome staining was used to visualize the smooth muscle.Results The group with PRP-coated meshes had a lower inflammatory infiltrate count at 30 days. Deposition of collagen III increased with the use of PRP-coating at 90 days.Conclusions The area of inflammatory infiltrate was significantly increased in the group without the PRP-coated mesh at 30 days but not in the group with the PRP-coated mesh, indicating a less intense inflammatory response. In addition, a significant increase in collagen III occurred at 90 days.

Platelet-rich plasma administration to the lower anterior vaginal wall to improve female sexuality satisfaction

“…It has been used in atrophic diseases such as vaginal lichen sclerosis, stress urinary incontinence, episiotomy scars, and lubrication disorders (2,19) . PRP has been found to be effective in mesh erosion; PRP-coated mesh treatment has been revealed by in vitro and animal studies to result in better wound healing, increased synthesis of collagen 3, and neovascularization (20,21) .…”

The importance of developing relevant animal models to assess existing and new materials

“…Vaginal exposure was observed in both the groups. In the animals without exposures, there were no differences in the inflammatory infiltrate apart from more immature collagen [48]. The above experiments have partially conflicting results, and neither were they designed to explore mechanisms behind these differences.…”

The Emerging Role on the Use of Platelet-Rich Plasma Products in the Management of Urogynaecological Disorders

“…More specifically, Parizzi et al reported a decreased inflammatory infiltration at 30 days and increased collagen III concentration at 90 days in the histologic specimen of PRP-coated meshes which were implanted in the vaginal mucosa of 15 rabbits. 28 On the contrary, Belebecha et al found reduced levels of myeloperoxidase and N-acetylglucosamide activities as well as decreased oxidative stress and elevated antioxidant levels without difference in inflammatory cells in the specimen of rabbits with PRP-coated polypropylene mesh compared to those with uncoated polypropylene mesh. 29 Finally, an in vitro study by Medel et al demonstrated the beneficial effect of PRP in enhancing the cell attachment to the surface of both Vicryl and Restorelle meshes compared to no PRP-coated meshes as proved by light microscopic evaluation (9875 ± 996 vs 1006 ± 84 cells/cm 2 , 9.8 times increase and 3724 ± 407 vs 649 ± 53 cells/cm 2 , 5.7 times increase, respectively).…”