Department of Pediatric Surgery, Hacettepe University, School of Medicine, Ankara, Turkey.
J Pediatr Surg. 2013 Dec;48(12):2545-9. doi: 10.1016/j.jpedsurg.2013.06.020.
Platelet rich fibrin (PRF) is an autologous source of growth factors and promotes wound healing. An experimental study was performed to evaluate the effect of PRF on growth factor levels in urethral repair.
Eighteen Wistar albino rats were included in the study. Rats were allocated in three groups (n:6): control (CG), sham (SG), and PRF (PRFG). In SG, a 5 mm vertical incision was performed in the penile urethra and repaired with 10/0 Vicryl® under a microscope. In PRFG, during the urethral repair as described in SG, 1 cc of blood was sampled from each rat and centrifuged for 10 minutes at 2400 rpm. PRF obtained from the centrifugation was placed on the repair site during closure. Penile urethras were sampled 24 hours after PRF application in PRFG and after urethral repair in SG. Transforming growth factor beta receptor (TGF-β-R-CD105), vascular endothelial growth factor (VEGF) and its receptor (VEGF-R), as well as endothelial growth factor receptor (EGFR), were evaluated in subepithelia of the penile skin and urethra. Groups were compared for growth factor levels and growth factor receptor expression with the Kruskal Wallis test.
TGF-β-R levels were significantly decreased in SG when compared to CG (p<0.05). In PRFG, TGF-β-R was increased in both subepithelia of penile skin and urethra with respect to SG (p<0.05). When VEGF levels and its receptor expression were compared between SG and PRFG, VEGF levels were found to be increased in penile skin subepithelium, whereas VEGF-R expressions were decreased in urethral subepithelia in PRFG (p<0.05). There was no difference between groups for EGFR levels (p>0.05).
Use of PRF after urethral repair increases TGF-β-R and VEGF expressions in urethral tissue. PRF can be considered as an alternative measure to improve the success of urethral repair.
富含血小板纤维蛋白（PRF）是生长因子的自体来源，可促进伤口愈合。进行了一项实验研究，以评估 PRF 对尿道修复中生长因子水平的影响。
本研究纳入了 18 只 Wistar 白化大鼠。将大鼠分为三组（n：6）：对照组（CG）、假手术组（SG）和 PRF 组（PRFG）。在 SG 中，在阴茎尿道上进行 5mm 垂直切口，并在显微镜下用 10/0 Vicryl®修复。在 PRFG 中，在 SG 中描述的尿道修复过程中，从每只大鼠中抽取 1cc 血液，并在 2400rpm 下离心 10 分钟。在闭合过程中，将离心获得的 PRF 放置在修复部位。PRFG 中在应用 PRF 后 24 小时和 SG 中在尿道修复后采样阴茎尿道。评估阴茎皮肤和尿道的上皮下转化生长因子β受体（TGF-β-R-CD105）、血管内皮生长因子（VEGF）及其受体（VEGF-R）以及内皮生长因子受体（EGFR）。使用 Kruskal Wallis 检验比较各组生长因子水平和生长因子受体表达。
与 CG 相比，SG 中 TGF-β-R 水平显著降低（p<0.05）。在 PRFG 中，与 SG 相比，阴茎皮肤和尿道的上皮下 TGF-β-R 均增加（p<0.05）。当比较 SG 和 PRFG 之间的 VEGF 水平及其受体表达时，发现阴茎皮肤上皮下 VEGF 水平增加，而 PRFG 中尿道上皮下 VEGF-R 表达减少（p<0.05）。各组之间 EGFR 水平无差异（p>0.05）。
尿道修复后使用 PRF 可增加尿道组织中的 TGF-β-R 和 VEGF 表达。PRF 可被视为改善尿道修复成功率的替代措施。
