The Effect of Platelet-Rich Plasma on Survival of the Composite Graft and the Proper Time of Injection in a Rabbit Ear Composite Graft Model

Abstract

BackgroundAdministration of growth factors has been associated with increased viability of composite grafts greater than 1-cm in diameter. Platelet-rich plasma (PRP) contains many of the growth factors studied. In this study, we evaluate the effect of PRP injection on composite graft viability and the proper time for injection.MethodsA total of 24 New Zealand White rabbits were divided into four groups. Autologous PRP was injected into the recipient sites three days before grafting in group 1, on the day of grafting in group 2, and three days after grafting in group 3. Group 4 served as control without PRP administration. Auricular composite grafts of 3-cm diameter were harvested and grafted back into place after being rotated 180 degrees. Median graft viability and microvessel density were evaluated at day 21 of graft via macroscopic photographs and immunofluorescent staining, respectively.ResultsThe median graft survival rate was 97.8% in group 1, 69.2% in group 2, 55.7% in group 3, and 40.8% in the control group. The median vessel counts were 34 (per ×200 HPF) in group 1, 24.5 in group 2, 19.5 in group 3, and 10.5 in the control group.ConclusionsThis study demonstrates that PRP administration is associated with increased composite graft viability. All experimental groups showed a significantly higher survival rate and microvessel density, compared with the control group. Pre-administration of PRP was followed by the highest graft survival rate and revascularization. PRP treatments are minimally invasive, fast, easily applicable, and inexpensive, and offer a potential clinical pathway to larger composite grafts.

Autologous platelet rich plasma - an adjunct to early tangential excision and grafting in burns

“…Pallua et al [9] have reported that application of platelet-rich plasma for burn patients accelerates re-epithelization. In another study by Choi et al [10] , the subcutaneous injection of platelet rich plasma in a rabbit skin flap was shown to promote vasculogenesis and increase flap survival.…”

The effect of deferoxamine injection on composite graft survival in rabbits

“…However, unlike skin grafts, composite grafts have a layer of cartilage, which can act as a mechanical barrier that limits the vascularization of the wound bed. Thus, it is conceivable that revascularization via the dermis connection to the dermis at the wound edge is more important for the survival of the composite graft, and in turn limits the size of the composite graft [ 11 ]. Because it is like a skin graft, the viability of the composite graft is influenced by good recipient vascularity, accurate contact between the graft and recipient, and immobilization [ 12 ].…”

“…The important role of VEGF in angiogenesis is as a specific mitogen factor for endothelial cells, which stimulates the formation of new blood vessels and increases their permeability. In PRP, there are many of the growth factors mentioned above which are proven to increase the viability of the composite graft [ 5 ].…”

Is the combination of fat grafts and platelet rich plasma effective in rats?

“…Platelets contain growth factors that stimulate neoangiogenesis and cell differentiation [5][6][7] . Platelets in PRP are obtained in anticoagulated state, therefore inert and require activation (usually accomplished by the addition of calcium chloride and / or thrombin) to release their growth factors 8,9 .…”

“…The association of fat grafts and PRP began to be studied in recent years 7,14 . This association is justifiable due to the pursuit of PRP as a mechanism to improve the viability and quality of fat grafts, mainly by stimulating neovascularization of the grafts.…”