The Effect of Platelet-Rich Plasma on Flap Survival in Random Extension of an Axial Pattern Flap in Rabbits

Background: Autologous platelet-rich plasma contains multiple growth factors. The aim of this randomized trial was to study the effect of an injection of platelet-rich plasma during random extension of an axial pattern flap procedure. Methods: Sixteen male New Zealand white rabbits were assigned randomly to two groups of eight animals each. A 10 x 10-cm unipedicled fasciocutaneous island flap was elevated. After flap elevation, the experimental group was injected evenly with platelet-rich plasma. For the control group, normal saline was injected into the same areas. The flap survival area was assessed 2 weeks after the operation. Microvessel density and mature vessel density were evaluated to examine the angiogenic and arteriogenic effects, respectively. Results: Flap survival was significantly increased in the experimental group (80.3 +/- 10.0 percent) compared with the control group (55.2 +/- 13.6 percent; p = 0.001). Immunohistologic staining showed that the microvessel density (38.8 +/- 11.0 per high-power field for the experimental group; 17.6 +/- 6.6 per high-power field for the control group; p = 0.001) and mature vessel density (16.3 +/- 4.1 per high-power field for the experimental group; 7.4 +/- 1.7 per high-power field for the control group; p = 0.001) were significantly higher in the experimental group than in the control group. Conclusions: The authors' data indicate that platelet-rich plasma injection significantly improves the surviving area of flaps through angiogenic and arteriogenic effects. Thus, it could be used in a clinical situation as a minimally invasive, fast, and easily applicable treatment.