The effect of PRP (Platelet rich plasma) on fascial healing during abdominal wall closure in the presence of fecal peritonitis

ABSTRACT THE EFFECT OF PRP (PLATELET RICH PLASMA) ON FASCIAL HEALING DURING ABDOMINAL WALL CLOSURE IN THE PRESENCE OF FECAL PERITONITIS Healing of abdominal wall fascia is based on the same principle with wound healing. The rate of recovery of the anterior abdominal wall fascia and quality such as infection depends on factors affecting wound healing. Fascia wound healing, tissue repair and healing are closely related. Incisional hernia soccured in a previous surgical area is considered to be a complication of surgery. The majority of this type of hernia is related to the anterior abdominal wall. Incisional hernias with significant loss of manpower, are causes of morbidity and even mortality. Anterior abdominal wall fascia healing influenced either by surgical factors or influenced by patient spesific factors, this conditions are known as risk factors for incisional hernia. It is known today, platelets are responsible for the activation of a variety of cells, especially stem cells, by secreting many bioactive proteins accelerating tissue regeneration and healing. Platelet Rich Plasma (PRP) includes high level of platelets, growth and clotting factors. PRP is applied to responding structures for tissue healing and regeneration. In this study we performed an unique experimental tecnique on rats. After performing fecal peritonitis, PRP was applied locally to see effects on fascia healing with the consideration of positive effect on wound healing. This study have used 28 rats, as being 7 rats in each groupe. Group 1 (control group): Primary fascia repair has done without perotonitis performed. Group 2; Fascia repair has done and local PRP has given without peritonitis performed. Group 3; Primary fascia repair has done with fecal peritonitis performed. Group 4; Fascia repair has done and local PRP has given with fecal peritonitis performed. In the study; histologicaly, cellulary infiltration, neovascularition, fibroblast activation, collagen accumulation observed. Biochemicaly, tissue hydroxiproline, TNF Alfa, TGF Beta levels were observed. TNF Alfa levels were higher in PRP given groups according to control group (p<0.001). TGF Beta levels were higher only in PRP given group with fecal peritonitis performed. Tissue hydroxyproline levels were not statisticaly different in groups (p>0.05). Inflammatory cellulary infiltration and collagen accumulation were not statisticaly different in groups (p>0.05). Neovascularition and fibroblast activation were increased statiscaly different in PRP given and PRP has given with fecal peritonitis performed groups. Neovascularition and fibroblast activation were decreased statistically in peritonitis performed group. When PRP has given histologicaly and biochemicaly as wound healing parameters cellular infiltration, collagen accumulation, and tissue hydroxyiproline levels were not increased but neovascularization, fibroblast activation and TNF Alfa levels were increased and PRP accelereted wound healing. We suggest that clinical application sand surgical studies will be important in the future to show positive effects of PRP on wound healing. Keywords: Platelet rich plasma, fascia healing, wound healing