Effect of platelet-rich plasma microinjections on the healing and histostructure of extended fasciocutaneous flaps based on axial blood supply

Purpose To reveal a possible effect of platelet-rich plasma (PRP) on healing and histostructure of extended fasciocutaneous flaps with axial blood supply Materials and methods A flap based on the superficial inferior epigastric artery (SIEA) and extended to the cranial side according to a template with an area of 18 cm2 was produced in 24 rats. After one-and-half hour femoral artery clipping for temporary ischemia, it was re-perfused and re-planted at the site of SIEA origination. After the operation, six microinjections of platelet-rich plasma (0.1 ml) were performed subdermally that were equally distributed on the flap. Comparison group had injections of saline in the similar number and zones. Control group had flaps without injections. Reference norm sites were skin contralateral areas. Twelve days after the operation, the animals are euthanized. Methods of the study were computer planimetry, histomorphometry, and immunohistochemistry. Results When compared with the control and placebo groups, a more than ten-fold reduction in the area of epidermal defects that were associated with delayed wound healing and necrotic complications was achieved. Polymorphic cell infiltration of the dermis decreased 1.7 times under the conditions of PRP microinjections when compared with the control group. Numerical density of capillaries in the subpapillary plexus doubled, and the number of dermal papillae increased 1.5 times. Discussion Enhancement of capillarization of the superficial skin structures proceeded with inhibition of inflammatory reactions and was probably caused by direct action of growth factors of platelets on endothelial cells. Conclusion PRP microinjections are able to effectively prevent partial necrosis of the extended fasciocutaneous flap based on axial blood supply, accelerate epithelization of the wound along the flap perimeter, and maintain the normal plasticity of the epidermis. There was no significant effect of the drug on the state of deep flap structures (subcutaneous fat and skin appendages).