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DOI: 10.1055/s-2008-1076752
Effect of Platelet-Rich Plasma on Peripheral Nerve Regeneration
Publication History
Publication Date:
30 April 2008 (online)
ABSTRACT
Activated platelets release various growth factors, some of which are recognized to improve nerve regeneration. This study evaluated the effect of platelet-rich plasma (PRP) in end-to-end neurorrhaphy. A total of 45 Wistar rats were used, with the initial five used for PRP preparation. The right hind limbs were used as experimental, with the left as control. The animals were treated in five groups. Group A (n = 4): The right sciatic nerve was dissected only from the sciatic notch to the bifurcation. In all other groups, the nerve was sharply transected and repaired with: group B (n = 8): two sutures; group C (n = 8): six sutures; group D (n = 10): two sutures and PRP; and group E (n = 10): six sutures and PRP. Groups D and E were compared with groups B and C, respectively. Group E had a shorter latency time in electromyography (p < 0.01) and a thicker myelin layer in the histological evaluation (p < 0.003) in comparison with group C. These positive effects of PRP were not detected in the nerves were repaired with two sutures. In this animal model, the application of PRP to the repair site helped to improve remyelinization of the sciatic nerve in rats when the epineural repair was done with six sutures.
KEYWORDS
Nerve regeneration - platelet-rich plasma - platelet gel
REFERENCES
- 1 Atabay K, Hong C, Heil B V et al.. The use of “sliding epineural sheath tube” for repair of peripheral nerve defects. Plast Surg Forum. 1995; 18 121-123
- 2 Lolley R D, Bose W J, Bastian F et al.. Vein, silastic and polyglycolic acid fine mesh: a comparative study in peripheral nerve repair. Ann Plast Surg. 1995; 35 266-271
- 3 Voinesco F, Glauser L, Kraftsik R et al.. Local administration of thyroid hormones in silicone chamber increases regeneration of rat transected sciatic nerve. Exp Neurol. 1998; 150 69-81
- 4 Wang K K, Nemeth I R, Seckel B R et al.. Hyaluronic acid enhances peripheral nerve regeneration in vivo. Microsurgery. 1998; 18 270-275
- 5 Gorgulu A, Imer M, Simsek O et al.. The effect of aprotinin on extraneural scarring in peripheral nerve surgery: an experimental study. Acta Neurochir (Wien). 1998; 140 1303-1307
- 6 Welch J A, Kraus K H, Wells M R et al.. Effect of combined administration of insulin-like growth factor and platelet-derived growth factor on the regeneration of transected and anastomosed sciatic nerve in rats. Am J Vet Res. 1997; 58 1033-1037
- 7 Frostick S P, Yin Q, Kemp G J. Schwann cells, neurotrophic factors, and peripheral nerve regeneration. Microsurgery. 1998; 18 397-405
- 8 Aspenberg P, Virchenko O. Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand. 2004; 75 93-99
- 9 Ozmen S, Ayhan S, Latifoglu O et al.. Stamp and paper method: a superior technique for the walking track analysis. Plast Reconstr Surg. 2002; 109 1760-1761
- 10 Bain J R, Mackinnon S E, Hunter D A. Functional evaluation of complete sciatic peroneal and posterior tibial nerve lesions in the rat. Plast Reconstr Surg. 1989; 83 129-138
- 11 Ozgenel G Y. Effects of hyaluronic acid on peripheral nerve scarring and regeneration in rats. Microsurgery. 2003; 23 575-581
- 12 Eppley B L, Woodell J E, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg. 2004; 114 1502-1508
- 13 Whitman D H, Berry R L, Green D M. Platelet gel: an autologous alternative to fibrin glue with applications in oral and maxillofacial surgery. J Oral Maxillofac Surg. 1997; 55 1294-1299
- 14 Marx R E, Carlson E R, Eichstaedt R M et al.. Platelet-rich plasma: growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85 638-646
- 15 Lowery G L, Kulkarni S, Pennisi A E. Use of autologous growth factors in lumbar spinal fusion. Bone. 1999; 25(2, Suppl) 47S-50S
- 16 Gehring S, Hoerauf H, Laqua H et al.. Preparation of autologous platelets for the ophthalmologic treatment of macular holes. Transfusion. 1999; 39 144-148
- 17 Man D, Plosker H, Winland-Brown J E. The use of autologous platelet-rich plasma (platelet gel) and autologous platelet-poor plasma (fibrin glue) in cosmetic surgery. Plast Reconstr Surg. 2001; 107 229-237
- 18 Kanje M, Skottner A, Lundborg G et al.. Does insulin-like growth factor I (IGF-1) trigger the cell body reaction in the rat sciatic nerve?. Brain Res. 1991; 563 285-287
- 19 Kanje M, Skottner A, Sjoberg J et al.. Insulin-like growth factor I (IGF-I) stimulates regeneration of the rat sciatic nerve. Brain Res. 1989; 486 396-398
- 20 Near S L, Whalen L R, Miller J A et al.. Insulin-like growth factor II stimulates motor nerve regeneration. Proc Natl Acad Sci U S A. 1992; 89 11716-11720
- 21 Sjoberg J, Kanje M. Insulin-like growth factor (IGF-1) as a stimulator of regeneration in the freeze-injured rat sciatic nerve. Brain Res. 1989; 485 102-108
- 22 Sondell M, Lundborg G, Kanje M. Vascular endothelial growth factor has neurotrophic activity and stimulates axonal outgrowth, enhancing cell survival and Schwann cell proliferation in the peripheral nervous system. J Neurosci. 1999; 19 5731-5740
- 23 Ridley A J, Davis J B, Stroobant P et al.. Transforming growth factors-beta 1 and beta 2 are mitogens for rat Schwann cells. J Cell Biol. 1989; 109 3419-3424
- 24 Davis J B, Stroobant P. Platelet-derived growth factors and fibroblast growth factors are mitogens for rat Schwann cells. J Cell Biol. 1990; 110 1353-1360
- 25 Danielsen N, Pettmann B, Vahlsing H L et al.. Fibroblast growth factor effects on peripheral nerve regeneration in a silicone chamber model. J Neurosci Res. 1988; 20 320-330
- 26 Hansson H A. Insulin-like growth factors and nerve regeneration. Ann N Y Acad Sci. 1993; 692 161-171
- 27 Menovsky T, Beek J F. Carbon dioxide laser-assisted nerve repair: effect of solder and suture material on nerve regeneration in rat sciatic nerve. Microsurgery. 2003; 23 109-116
- 28 Ploncard P. Comparative study of circumferential nerve suture using the operating microscope. Electrophysiological and histological control. Acta Neurochir (Wien). 1976; 34 175-183
- 29 Jubran M, Widenfalk J. Repair of peripheral nerve transections with fibrin sealant containing neurotrophic factors. Exp Neurol. 2003; 181 204-212
- 30 Santos X, Rodrigo J, Hontanilla B et al.. Local administration of neurotrophic growth factor in subcutaneous silicon chambers enhances the regeneration of the sensory component of the rat sciatic nerve. Microsurgery. 1999; 19 275-280
- 31 Voinesco F, Glauser L, Kraftsik R et al.. Local administration of thyroid hormones in silicone chamber increases regeneration of rat transected sciatic nerve. Exp Neurol. 1998; 150 69-81
- 32 Wong C, Inman E, Spaethe R et al.. Fibrin-based biomaterials to deliver human growth factors. Thromb Haemost. 2003; 89 573-582
- 33 Midha R, Munro C A, Dalton P D et al.. Growth factor enhancement of peripheral nerve regeneration through a novel synthetic hydrogel tube. J Neurosurg. 2003; 99 555-565
- 34 Weibrich G, Kleis W K, Hafner G et al.. Growth factor levels in platelet-rich plasma and correlations with donor age, sex, and platelet count. J Craniomaxillofac Surg. 2002; 30 97-102
Yakup SariguneyM.D.
Department of Plastic, Reconstructive and Aesthetic Surgery
Gazi University Faculty of Medicine, Ankara, Turkey