Effect of platelet rich fibrin on healing experimental nerve damaged in rabbits

This study was conducted to investigate the effect of autogenous platelet-rich fibrin (PRF) in the treatment of nerve injuries. Twenty eight 5-6 month old male New Zealand rabbits were used in the study. The rabbits were randomly and equally divided into two main groups as control and treatment groups. Before the operation, 8 ml of blood was taken from the rabbits in the treatment group and TZF was prepared by centrifugation at 400g for 10 minutes. Under general anesthesia, a skin incision was made on the medial aspect of the foreleg from the distal part of the articulatio humeri joint to the distal part of the articulatio cubiti joint. The fasciae were cut, muscles were excised and the root of the plexus brachialis was exposed. In all rabbits, nerve damage was induced by applying pressure to the n. radialis and n. ulnaris with aneurysm clamps for 90 seconds.In the control group, after the aneurysm clamps were removed, the operation area was closed without any procedure. In rabbits in the treatment (PRF) group, after the aneurysm clamps were removed, the damaged nerve areas were covered with autogenous PRF prepared just before the operation. The operation area was closed in accordance with routine surgical rules. Postoperatively, 14 rabbits were followed up for 30 days and 14 rabbits for 60 days. Rabbits were subjected to weekly clinical examination. The animals were evaluated for clinical examination findings consisting of response to foot pull, response to deep pain sensation, and grasping movements. Electromyography was performed before the operation, immediately after the operation, and on the 30th and 60th days. 7 rabbits from each group were sacrificed on the 30th day and the remaining 7 rabbits were sacrificed on the 60th day. For histopathological controls, intact nerve tissue in the proximal and distal of the damaged nerve tissue was also taken. After examining the changes observed in all groups clinically, electromyographically and microscopically, statistical evaluations of the obtained data were performed. A significant difference was observed between the PRF groups and the control groups in clinical findings. In EMG findings; when the initial amplitude/ final amplitude values were compared, no significant difference was found in the reference values, whereas significant differences were found in the 30-day groups (control/PRF) and 60-day groups (control/PRF). In histopathological findings, degenerative changes were found less in TZF groups and regenerative changes were found more in TZF groups compared to control groups. Clinical, EMG and histopathological findings show the positive contribution of PRF to recovery in experimental nerve injuries (p<0,05). In conclusion; it was concluded that PRF can be used in the repair of nerve injuries due to its tissue compatibility, suppression of inflammation and infection, and acceleration of vascularization and healing.