Platelet rich plasma enhances tissue incorporation of biologic mesh

Joseph S. Fernandez-Moure, Jeffrey L. Van Eps, Zachary K. Menn, Fernando J. Cabrera, Ennio Tasciotti, Bradley K. Weiner, Warren A. Ellsworth

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15 Scopus citations

Abstract

Background: High recurrence rates because of poor tissue incorporation limit the use of acellular dermal matrices (ADMs) in ventral hernia repair (VHR). Platelet rich plasma (PRP) is a growth factor–rich autologous blood product known to enhance tissue repair through cellular proliferation and neovascularization. We sought to study the effect of PRP on a porcine noncross-linked ADM in an in vivo model of VHR. We hypothesized that PRP would enhance ADM-tissue incorporation in a rat model of VHR. Methods: Whole blood was extracted from Lewis rats followed by PRP isolation and characterization. Using a rat model of VHR, a noncross-linked ADM (Strattice) was implanted and activated PRP applied before closure. Rats were sacrificed at 2, 4, and 6 wk. Immunohistochemical staining of CD 31 on endothelial cells was used to quantify neovascularization. Hematoxylin eosin stained tissues were measured to quantify tissue deposition. Results: Platelet concentration of PRP was standardized to 1 × 106 platelets/μL. Grossly, vessels were more evident in PRP-treated rats. Immunohistochemical analysis demonstrated neovascularization was significantly greater in the PRP-treated ADMs at all time points. This increase in neovascularization correlated with an increased thickness of tissue deposition at 4 and 6 wk. Conclusions: PRP enhanced neovascularization and incorporation in a rat model of VHR. Enhanced neovascularization was associated with earlier and greater tissue deposition on the ADM. This suggests that PRP could be used as an adjunct to VHR in clinical scenarios where poor wound healing is anticipated and enhanced neovascularization and early tissue deposition are desired.

Original languageEnglish (US)
Pages (from-to)412-419
Number of pages8
JournalJournal of Surgical Research
Volume199
Issue number2
DOIs
StatePublished - Dec 2015

Bibliographical note

Funding Information:
This study was funded in part by a grant from the Defense Advanced Research Projects Agency (DARPA) titles: BioNanoScaffolds (BNS) for Post-Traumatic Osteoregeneration Project ID W911NF-09-1-0044. Authors' contributions: J.S.F.-M. did animal surgeries, collection and assembly of data, development of rat model, histological staining, data analysis and interpretation, and article writing; J.L.V.E. did animal surgeries, collection of data, data analysis, and article preparation; Z.K.M. contributed to collection and assembly of histological data; F.J.C. did animal surgeries and histological processing; E.T. and B.K.W. contributed to financial and administrative support, interpretation of data, revision of critical intellectual data, and final approval of draft; and W.A.E. contributed to design of the work, interpretation of data, and final approval of the article.

Publisher Copyright:
© 2015 Elsevier Inc.

Keywords

  • Acellular dermal matrix
  • Angiogenesis
  • Hernia
  • Incorporation
  • Platelet rich plasma
  • Strattice

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