The Effects of Inactive Platelet-rich Plasma at Different Injection Time on Prefabricated Flap Viability in Rabbits

To evaluate the effect of inactive form of platelet-rich plasma (PRP) at different injection time on the prefabricated flap viability in rabbits.

A thoracodorsal artery vascular bundle prefabricated flap was established on the back of 30 healthy male New Zealand white rabbits by 2 phases of operations. A total of 60 sides were randomly divided into the experimental side and the control side. The experimental side was injected with autologous inactive PRP around the thoracodorsal vascular bundle, and the control side was injected with the same amount of normal saline. According to preoperative (group A), intraoperative (group B), and postoperative (group C) injection of PRP, 30 rabbits were divided into 3 groups of 10 each. Histological and immunohistochemical observation, vascular density measurement, and lead oxide angiography were used to compare the differences in the survival of prefabricated flaps between the 3 groups of rabbits injected with inactive PRP at different injection time.

The flap survival ratio, microvessels density, vascular endothelial growth factor and vascular endothelial growth factor receptor 2 expression of PRP injection side were significantly improved compared with the control side. In the comparison of 3 injection time groups, we found that group A and group B could achieve better results, and especially group B had the most significant effect on the revascularization and flap viability.

Autologous inactive PRP can promote the survival of the prefabricated flap, and the intraoperative injection can significantly improve the survival rate of the prefabricated flap. It provides a theoretical guidance for obtaining a larger area of prefabricated axial flap in clinical practice.