The effect of platelet rich plasma on pedicle dissection time and delay phenomenon in pedicled flaps

SUMMARYTwo experimental models were designed to study effects of platelet rich plasma onshortening pedicle ligation time and achieving delay phenomenon pharmacologically.In the first study bilateral epigastric flaps were elevated in 24 rats. Right-sided flapswere control flaps of the left side. In Group I (n=8) platelet rich plasma, in Group II (n=8)fibrin glue (FG) and in Group III (n=8) thrombin had been applied to the flap site. One weeklater all flap pedicles were ligated. In the second study right unipedicled epigastric flaps wereelevated in 24 rats. One week before flap elevation saline solution had been applied under theflap area in Group 1 (n=6). Same procedure was performed with platelet rich plasma in Group2 (n=6), fibrin glue in Group 3 (n=6), thrombin in Group 4 (n=6) instead of saline. One weeklater flaps were elevated in first three groups. In Group 4 as abdominal area had undergonenecrosis, flap elevation couldn?t have been achieved. Flap necrosis was measured on theseventh day. While two rats from each group were examined microangiographically,histological evaluation was performed on tissue samples of all rats.PRP reduced amount of necrosis in both studies when compared to fibrin glue,thrombin and control groups. Histologically and microangiographically increased number ofarterioles were observed in platelet rich plasma applied groups. Increased necrosis in the firststudy?s thrombin applied group showed concordance with the second study?s necrosis resultsthat occured after thrombin application.This study demonstrates that platelet rich plasma might shorten pedicle division time,and provide delay effect pharmacologically. As thrombin increases necrosis, it is not suitablein flap surgery when used alone.