Platelet rich plasma may enhance peripheral nerve regeneration after cyanoacrylate reanastomosis: a controlled blind...

The aim of this study was to explore the ability of platelet rich plasma (PRP) to promote peripheral nerve regeneration after cyanoacrylate reanastomosis in rats. A total of 18 rats were used in this study. Bilateral sciatic neurotomies were performed in 15 rats, and then immediately reanastomosed with cyanoacrylate glue. On one side (G1), the anastomosed nerves were treated with prepared autologous PRP gel; on the contralateral side (G2) the nerves received no additional treatment. Sham surgery was undertaken on the remaining 3 rats (6 cases) where bilateral sciatic nerves were surgically approached but not cut (passive control group, (G3). Biopsies were harvested 12 weeks postoperatively and examined under the light microscope using osmic acid stain. The number of nerve fibers in the distal and proximal nerve segments of G1 and G2 as well as in G3 were counted and the results analyzed and compared. Animals in G1 and G2 showed some weakness and ulceration in their right and left feet for a few weeks postoperatively, which gradually improved during the follow-up period. The histomorphometric assessment showed a higher axon count in the distal segment of G1 (291.7 axons) compared with that of G2 (280.5 axons) (P=0.001). Similar results were noticed when the proximal segments of both groups were compared (P=0.040). These results were reflected in the values of the neurotization indices of G1 (91.9%) and G2 (89.5%) (P=0.008). The number of nerve fibers in G1 and G2 remained lower than in G3 (P=0.0001). The authors conclude that PRP may enhance the number of regenerating nerve fibers after cyanoacrylate neruoanastomosis.