Subcutaneous Injections of Platelet-Rich Plasma into Skin Flaps Modulate Proangiogenic Gene Expression and Improve Survival Rates
Subcutaneous Injections of Platelet-Rich Plasma into Skin Flaps Modulate Proangiogenic Gene Expression and Improve Survival Rates
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DOI：
10.1097/prs.0b013e3182450ac9
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发表时间：
2012-04-01
影响因子：
3.6
通讯作者：
Okawa, Atsushi
中科院分区：
文献类型：
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作者：
Li, Weiwei;Enomoto, Mitsuhiro;Okawa, Atsushi
背景：皮瓣坏死仍然是重建手术的主要并发症。为了提高皮瓣的存活率，使用血管扩张剂、抗血小板药物或局部给予生长因子进行了各种治疗。然而，对皮肤坏死的充分预防还没有很好地建立。富血小板血浆已被用作自体因子，并包括各种生长因子。作者评价是否富血小板血浆可以提高皮瓣存活率在一个实验rat model.Methods：颅底背皮瓣在48只大鼠。动物接受皮下注射富血小板血浆（100 μ l）或贫血小板血浆（100 μ l）。将大鼠分为富血小板血浆组（n = 16）、贫血小板血浆组（n = 16）和未治疗组（n = 16）。在第7天测量皮瓣存活率并收集组织学标本。实时聚合酶链反应标本收集后8小时，24小时，3天，7 day.Results：血小板丰富的血浆显着提高皮瓣成活率（61.2%）相比，血小板贫乏的血浆治疗（35.8%）和非治疗组（28.0%）。组织学分析表明，显着较少的炎性细胞和血管密度增加，观察到在血小板丰富的血浆大鼠与血小板贫乏的血浆或非治疗大鼠。此外，富血小板血浆治疗显着增加了血管内皮生长因子和血小板源性生长因子的mRNA水平。结论：富血小板血浆调节参与血管生成的基因，提高皮瓣成活率。（Plast。重建129：858，2012）。
Background: Flap necrosis remains a major complication of reconstructive surgery. To improve skin flap survival, various treatments with vasodilators, antiplatelet drugs, or the local administration of growth factors have been performed. However, the sufficient prevention of skin necrosis is not well established. Platelet-rich plasma has been used as an autologous factor and includes various growth factors. The authors evaluated whether or not platelet-rich plasma can improve skin flap survival in an experimental rat model.Methods: Cranially based dorsal cutaneous flaps were elevated in 48 rats. The animals received subcutaneous injections of either platelet-rich plasma (100 mu l) or platelet-poor plasma (100 mu l). The rats were divided into three groups: the platelet-rich plasma group (n = 16), the platelet-poor plasma group (n = 16), and the nontreatment group (n = 16). Flap survival was measured and histologic specimens were collected on day 7. Real-time polymerase chain reaction specimens were collected after 8 hours, 24 hours, 3 days, and 7 days.Results: Platelet-rich plasma significantly improved flap survival rates (61.2 percent) compared with the platelet-poor plasma treatment (35.8 percent) and nontreatment groups (28.0 percent). A histologic analysis showed that significantly fewer inflammatory cells and an increased blood vessel density were observed in the platelet-rich plasma rats versus the platelet-poor plasma or nontreatment rats. In addition, platelet-rich plasma treatment significantly increased the mRNA levels of vascular endothelial growth factor and platelet-derived growth factor.Conclusion: Platelet-rich plasma modulates the genes involved in angiogenesis and improves skin flap survival. (Plast. Reconstr. Surg. 129: 858, 2012.)