Gómez-Caro Abel, Ausin Pilar, Boada Marc
General Thoracic Surgery Department, Thorax Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
Interact Cardiovasc Thorac Surg. 2011 Dec;13(6):552-6. doi: 10.1510/icvts.2011.273995. Epub 2011 Aug 11.
This study investigated whether platelet-rich plasma (PRP) promotes healing and reduces anastomotic complications following airway surgery in a pig model. PRP was obtained by spinning down the animal's own blood (60 ml) and collecting the buffy coat containing platelets and white blood cells. Fifteen adult pigs were randomized into three groups: (1) sham treatment (cervicotomy), (2) non-PRP group (50% tracheal resection and end-to-end anastomosis), and (3) PRP group (50% tracheal resection, end-to-end anastomosis and PRP application). Blood samples were taken at baseline and at one, six and 24. Animals were monitored for anastomotic complications, infection and local reactivity. Laser Doppler flowmetry was performed intraoperatively and at 30 days to assess differences in pre- and post-anastomotic blood flow. The tensile strength of the anastomosis was also tested. The platelet level was higher in PRP fluid than in the baseline blood sample (P<0.002). Vascular endothelial growth factor, transforming growth factor β-1 and epidermal growth factor immunoassay readings peaked at one and six hours in the animals that had received PRP (P<0.03); these also showed significantly increased transanastomotic flow and stress-strain resistance (P<0.04) at 30 days than the animals that had not received PRP. PRP therefore, accelerates the onset of healing in airway surgery by promoting an earlier release of platelet-derived growth factors that stimulate transanastomotic angiogenesis.
本研究在猪模型中探究了富血小板血浆(PRP)是否能促进气道手术后的愈合并减少吻合口并发症。通过离心动物自身血液(60毫升)并收集含有血小板和白细胞的血沉棕黄层来获取PRP。15只成年猪被随机分为三组:(1)假手术组(颈部切开术),(2)非PRP组(50%气管切除并端端吻合),以及(3)PRP组(50%气管切除、端端吻合并应用PRP)。在基线、1小时、6小时和24小时采集血样。监测动物的吻合口并发症、感染和局部反应性。术中及术后30天进行激光多普勒血流仪检测,以评估吻合口前后血流的差异。还对吻合口的拉伸强度进行了测试。PRP液中的血小板水平高于基线血样(P<0.002)。在接受PRP的动物中,血管内皮生长因子、转化生长因子β-1和表皮生长因子免疫测定读数在1小时和6小时达到峰值(P<0.03);与未接受PRP的动物相比,这些动物在30天时的吻合口血流和应力应变阻力也显著增加(P<0.04)。因此,PRP通过促进血小板衍生生长因子的更早释放来刺激吻合口血管生成,从而加速气道手术中的愈合进程。