Platelet-rich plasma reduces skin flap inflammatory cells infiltration and improves survival rates through induction of angiogenesis: An experiment in rabbits

Abstract

Background: This study was conducted to evaluate the effects of platelet-rich plasma (PRP) on flap survival in an experimental rabbit model. Methods: Symmetrical rectangular dorsal cutaneous flaps (8 × 2 cm) were elevated in 15 rabbits. The rabbits were randomly divided into a 3-day group (n = 5), a 7-day group (n = 5), and a 14-day group (n = 5). Either side of the dorsum was selected for injection of PRP into the flap basal surface, while the other side received an equal volume of saline as a control. The flaps were immediately sutured back, after which the flap survival was measured and histology specimens were collected at 3, 7, and 14 days. Results: Platelet-rich plasma significantly improved flap survival rates of the PRP side flaps relative to the control in the 3-day (74.4% ± 4.7% vs 65.8% ± 6.8%; p < 0.05), 7-day (72.4% ± 7.5% vs 58.5% ± 7.0%; p < 0.05), and 14-day (74.5% ± 5.0% vs 65.0% ± 5.4%; p < 0.05) groups. Histological analysis revealed significantly fewer inflammatory cells and an increased blood vessel density in the platelet-rich plasma side flap vs the blank control side flap. Conclusion: Platelet-rich plasma (PRP) promotes the survival of random rabbit flaps and, therefore, represents a promising treatment to prevent skin flap necrosis in reconstructive and plastic surgery.

Keywords:

• Platelet-rich plasma
• skin flap
• neovascularisation
• survival rate

Acknowledgements

This work was supported in part by the 175th Hospital of the Chinese People’s Liberation Army (PLA), Affiliated Southeast Hospital of XiaMen University.

Disclosure statement

The authors report no conflicts of interest. The first author is responsible for the writing of the paper.

Funding information

This work was supported by Nanjing Military Region Scientific Research Fund Project on The Surface of A Class (11MA079).