CC BY-NC 4.0 · Arch Plast Surg 2014; 41(06): 647-653
DOI: 10.5999/aps.2014.41.6.647
Original Article

The Effect of Platelet-Rich Plasma on Survival of the Composite Graft and the Proper Time of Injection in a Rabbit Ear Composite Graft Model

Hyun Nam Choi
Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
,
Yea Sik Han
Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
,
Sin Rak Kim
Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
,
Han Kyeol Kim
Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
,
Hyun Kim
Department of Anatomy, Kosin University College of Medicine, Busan, Korea
,
Jin Hyung Park
Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
› Author Affiliations

Background Administration of growth factors has been associated with increased viability of composite grafts greater than 1-cm in diameter. Platelet-rich plasma (PRP) contains many of the growth factors studied. In this study, we evaluate the effect of PRP injection on composite graft viability and the proper time for injection.

Methods A total of 24 New Zealand White rabbits were divided into four groups. Autologous PRP was injected into the recipient sites three days before grafting in group 1, on the day of grafting in group 2, and three days after grafting in group 3. Group 4 served as control without PRP administration. Auricular composite grafts of 3-cm diameter were harvested and grafted back into place after being rotated 180 degrees. Median graft viability and microvessel density were evaluated at day 21 of graft via macroscopic photographs and immunofluorescent staining, respectively.

Results The median graft survival rate was 97.8% in group 1, 69.2% in group 2, 55.7% in group 3, and 40.8% in the control group. The median vessel counts were 34 (per ×200 HPF) in group 1, 24.5 in group 2, 19.5 in group 3, and 10.5 in the control group.

Conclusions This study demonstrates that PRP administration is associated with increased composite graft viability. All experimental groups showed a significantly higher survival rate and microvessel density, compared with the control group. Pre-administration of PRP was followed by the highest graft survival rate and revascularization. PRP treatments are minimally invasive, fast, easily applicable, and inexpensive, and offer a potential clinical pathway to larger composite grafts.

This article was presented at the 3rd Research and Reconstructive Forum on May 9-10, 2013 in Daegu, Korea and at The 88th Plastic Surgery the Meeting on October 11-15, 2013 in San Diego, CA, USA.




Publication History

Received: 28 April 2014

Accepted: 16 June 2014

Article published online:
05 May 2022

© 2014. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • References

  • 1 Aden KK, Biel MA. The evaluation of pharmacologic agents on composite graft survival. Arch Otolaryngol Head Neck Surg 1992; 118: 175-178
  • 2 Brown JB, Cannon B. Composite free grafts of two surfaces of skin and cartilage from the ear. Ann Surg 1946; 124: 1101-1107
  • 3 Fann PC, Hartman DF, Goode RL. Pharmacologic and surgical enhancement of composite graft survival. Arch Otolaryngol Head Neck Surg 1993; 119: 313-319
  • 4 Hartman DF, Goode RL. Pharmacologic enhancement of composite graft survival. Arch Otolaryngol Head Neck Surg 1987; 113: 720-723
  • 5 Chen IC, Yang RS, Ou LF, Tang YW, Jian MJ. The influence of intra-graft heparin injection on the survival of composite grafts. Zhonghua Yi Xue Za Zhi (Taipei) 1998; 61: 346-352
  • 6 Conley JJ, Vonfraenkel PH. The principle of cooling as applied to the composite graft in the nose. Plast Reconstr Surg (1946) 1956; 17: 444-451
  • 7 Li EN, Menon NG, Rodriguez ED. et al. The effect of hyperbaric oxygen therapy on composite graft survival. Ann Plast Surg 2004; 53: 141-145
  • 8 Hom DB, Winters M. Effects of angiogenic growth factors and a penetrance enhancer on composite grafts. Ann Otol Rhinol Laryngol 1998; 107: 769-774
  • 9 Yoo YC, Hong SP, Lee DH. Effect of angiogenic factor (PDGF-BB) on composite graft survival. J Korean Soc Plast Reconstr Surg 1995; 22: 971-987
  • 10 Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg 2004; 62: 489-496
  • 11 Frechette JP, Martineau I, Gagnon G. Platelet-rich plasmas: growth factor content and roles in wound healing. J Dent Res 2005; 84: 434-439
  • 12 Kim SJ, Choi WI, Lee BI, Park SH, Park C, Koo SH. The effect of platelet-rich plasma (PRP) on the survival of the autologous fat graft. J Korean Soc Plast Reconstr Surg 2007; 34: 291-297
  • 13 Henrich DE, Logan TC, Lewis RS, Shockley WW. Composite graft survival. An auricular amputation model. Arch Otolaryngol Head Neck Surg 1995; 121: 1137-1142
  • 14 Neligan RC. Plastic surgery. 3rd ed. London: Elsevier Sanders; 2013
  • 15 Rees TD. The transfer of free composite grafts of skin and fat: a clinical study. Plast Reconstr Surg Transplant Bull 1960; 25: 556-564
  • 16 Ballantyne Jr DL, Converse JM. Vascularization of composite auricular grafts transplanted to the chorio-allantois of the chick embryo. Transplant Bull 1958; 5: 373-377
  • 17 Hom DB, Maisel RH. Angiogenic growth factors: their effects and potential in soft tissue wound healing. Ann Otol Rhinol Laryngol 1992; 101: 349-354
  • 18 Bir SC, Esaki J, Marui A. et al. Therapeutic treatment with sustained-release platelet-rich plasma restores blood perfusion by augmenting ischemia-induced angiogenesis and arteriogenesis in diabetic mice. J Vasc Res 2011; 48: 195-205
  • 19 El-Sharkawy H, Kantarci A, Deady J. et al. Platelet-rich plasma: growth factors and pro- and anti-inflammatory properties. J Periodontol 2007; 78: 661-669
  • 20 Pallua N, Wolter T, Markowicz M. Platelet-rich plasma in burns. Burns 2010; 36: 4-8
  • 21 Li W, Enomoto M, Ukegawa M. et al. Subcutaneous injections of platelet-rich plasma into skin flaps modulate proangiogenic gene expression and improve survival rates. Plast Reconstr Surg 2012; 129: 858-866
  • 22 Zhou Z, Christofidou-Solomidou M, Garlanda C, DeLisser HM. Antibody against murine PECAM-1 inhibits tumor angiogenesis in mice. Angiogenesis 1999; 3: 181-188
  • 23 Muller AM, Hermanns MI, Skrzynski C, Nesslinger M, Muller KM, Kirkpatrick CJ. Expression of the endothelial markers PECAM-1, vWf, and CD34 in vivo and in vitro. Exp Mol Pathol 2002; 72: 221-229
  • 24 Skalli O, Pelte MF, Peclet MC. et al. Alpha-smooth muscle actin, a differentiation marker of smooth muscle cells, is present in microfilamentous bundles of pericytes. J Histochem Cytochem 1989; 37: 315-321
  • 25 Breuing K, Eriksson E, Liu P, Miller DR. Healing of partial thickness porcine skin wounds in a liquid environment. J Surg Res 1992; 52: 50-58