Application of autologous platelet-rich plasma in herniology: First results of a chronic experiment

Introduction. The causes of complications of hernioplasty are technical errors and the biological conditions in which the implant is placed. PRP is rich in growth factors and, by influencing cellular mechanisms, can improve the integration processes of a mesh implant.

Aim. To evaluate the quality of regeneration using PRP and improve the immediate and long-term results of allogernoplasty.

Materials and methods. The experiment was conducted on 6 pigs of the breed Topigs Large white, which underwent allogernoplasty of the anterior abdominal wall Sublay. In the main group (n = 3), the operation was completed with the application of a PRP mesh implant obtained from the blood of an operated pig. In the control group (n = 3), the operation was completed without using PRP. The nature of the scar was determined by the Vancouver scale, the severity of the postoperative pain syndrome was determined by a combination of facial features. For morphological examination, two 2.5 x 0.5 cm biopsies were excised along the edges of the implant on days 7, 14, 21, and 28 of the experiment. Histological preparations were stained with hematoxylin and eosin.

Results. The duration of epithelialization in the main group was 10 days, edema and hyperemia persisted for 48 hours. In the comparison group, the epithelialization time was 25 days, and edema resolution was on 5–6 days (p < 0.05). Morphological examination determined the granulation zone and thin-walled vessels on day 14 in the main group. On the 21st day, newly formed lymphatic vessels were detected. In the main group, alarge number of macrophages and cells of maturing and mature granulation tissue were detected at different stages of repair. On day 60, degenerative changes in nerve stem cells and perineural fibrosis were detected in the control group.

Discussion. In the main group, the acceleration of epithelialization processes and early activation of animals were noted, as well as the course of inflammation different from conventional allogernoplasty – rapid elimination of decay products, replacement of neutrophilic inflammation by elements of the monocyte-macrophage series, healing without the formation of a rough scar and wrinkling of the implant, absence of perineural fibrosis. Active neovascularization processes indicate an influx of oxygen into the repair zone and adequate lymphatic drainage, which prevents tissue edema.

Conclusion. The conducted experimental study confirms the expediency of using PRP in allogernioplasty.

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