Utilização de plasma rico em plaquetas para estimulação da angiogênese em flape de padrão axial toracodorsal em coelhos (Oryctolagus cuniculus)

Abstract

Wounds of large tracts with loss of tissue viability and delayed healing by secondary intention are cases where it is necessary the use of reconstructive surgical techniques. The platelet rich plasma (PRP) is a product with a higher platelet concentration, adjuvant in the healing process of reconstructive surgeries, assisting in the processes of hemostasis and stimulation of angiogenesis. Thus, a study was devised to assess the efficacy of the gel produced from the platelet rich plasma (PRP) in the forward axial flaps thoracodorsal pattern in rabbits to evaluate the ability to promote the integration of the flap the recipient bed. We used 30 white rabbits New Zealand, separated into two groups of 15 animals, comprising the platelet rich plasma groups (GPRP), in which we used the gel before the synthesis of the surgical wound , and control (CG), in which only saline was used. To obtain the PRP, the blood was collected from the animals, was determined and the platelet count before preparation of the gel. At the beginning and end of the experiment the animals were weighed for analysis of average weight gain. After surgery began macroscopic in the 3rd, 7th and 14th day reviews, and we assessed the presence or absence of exudate, skin integrity, edema, redness and necrosis. After this step, yielded the material for the manufacture of surgical wound, followed by microscopic histological slides. We evaluated vascular proliferation, presence of polymorphonuclear and mononuclear cells, fibroblast proliferation, collagen deposition, reepithelialization and hemorrhage. The data were subjected to statistical analysis (Student t test, t paired, and Kruskal Wallis test, and p<0.05). The average weight gain was not significant between the groups; platelet concentration in the final sample of PRP was significantly higher when compared with the original; exudate and necrosis were significantly higher in the control group compared to PRP group, vascular proliferation and reepithelialization were significantly greater in PRP group, whereas the presence of mononuclear cells, polymorphonuclear cells, proliferation of fibroblasts, collagen and hemorrhage were not significant between groups. Obtained on the third day, as the difference significantly greater exudate variable in the control group compared to the PRP group; on 1 Recebido em 14 de fevereiro de 2015.Aceito para publicação em 22 de setembro de 2015.

Efecto de un concentrado autólogo de plaquetas en colgajos cutáneos en conejos

“…El presente estudio demostró que una rama cutánea de la arteria subescapular garantizó el aporte sanguíneo de colgajos toraco-dorsales de tamaño pequeño tratados o no con plasma rico en plaquetas (CAP), evitando la presentación de alteraciones relacionadas con la irrigación. Pazzini et al (2016) reportaron el uso de la arteria y vena toraco-dorsal en colgajos de patrón axial suturados en el codo en conejos. En su estudio, los autores evidenciaron necrosis en la porción distal de los tejidos causado posiblemente por la obliteración del vaso sanguíneo en el pedículo, impidiendo una perfusión adecuada al tejido movilizado, dando lugar a procesos de isquemia (Lucas, 2017).…”

Skin Grafts Associated with Platelet Rich Plasma and Surgical Sponge - Literature Review

“…Platelet-rich plasma is regarded as an adjuvant product in the healing process of reconstructive surgery because of its auxiliary potential in stimulating processes of new blood vessels (Pazzini et al, 2016a). However, other authors report some contradictory results through the use of the product, and suggest that more experimental studies need to be done in order to really demonstrate efficacy of the product, and also emphasize that more research is needed in veterinary medicine because there are few experimental works related to the use of PRP (Garcia, 2005).…”

“…The grafts are devoid of artery and vein in its constitution, so are affected by necrosis after implanted in the recipient region (Tobias, 2011). After faced with these problems, many authors have reported the use of substances to improve healing, by stimulating angiogenesis, which was boosted by the use of platelet-rich plasma (PRP) in surgical wounds (Vendramin et al, 2010;Pazzini et al, 2016a).…”

Surgical sponge associated with platelets rich plasma in skin mesh grafts and layer in rabbits (Oryctolagus cuniculus)

“…Thus, the problems encountered related to neovascularization in surgical procedures are the subject of many studies, and the platelet-rich plasma (PRP) is a substance that has been researched to have factors that stimulate angiogenesis and aid in tissue repair (Santos, 2007). Studies indicate that this product can stimulate various processes involved in tissue recovery mainly epithelialization and angiogenesis (Pazzini et al, 2016a).…”