Comparison of the effects of platelet-rich plasma and plasma rich in growth factors on anastomotic healing in pigs.

Background: Autologous regenerative medicine has recently gained interest in different medical fields, and studies have been undertaken in order to examine the effect of platelet-rich plasma(PRP) on intestinal healing. The aim of this study is to compare the effects on intestinal healing of two different autologous plasma preparations: PRP and plasma rich in growth factors(PRGF). Methods: Six pigs were subjected to handsewn jejuno-jejunal anastomoses, and randomly assigned to two groups. In all animals two anastomosis served as controls. In group A, PRP was applied to the remaining 4 anastomosis, and in group B PRGF was applied to the remaining 4 anastomosis. PRP/PRGF were obtained after centrifugation of venous blood and then activated just before application. The intestinal edges were immerged into the activated preparation until it had completely gelled. The anastomosis was then completed. All animals were euthanased 8 days after. At necropsy adhesions, leakage, presence of granulomas at the anastomotic site were recorded. Bursting pressure was measured for each anastomosis and compared. Samples were submitted for histopathology to evaluate epithelialization, ulceration, inflammation, fibroplasia and neovascularization. Results There was no evidence of leaking at anastomotic sites. Adhesions were more present on PRP samples. Bursting pressure was higher with PRGF but not significantly. Histologically no difference was found in the grade of inflammation, fibroplasia or neovascularization. Mucosal epithelialization was complete in a higher number of cases treated with PRGF compared to PRP and controls. Conclusions In the early phases of intestinal healing PRGF improves mucosal epithelialization while reducing mucosal ulceration in jejunal anastomosis in pigs.