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. 2013 Dec 16:2013:864350.
doi: 10.1155/2013/864350.

The effect of autologous platelet-rich plasma on bronchial stump tissue granulation after pneumonectomy: experimental study

Eleftherios Spartalis  1 , Periklis Tomos  1 , Petros Konofaos  1 , Grigorios Karagkiouzis  1 , Georgia Levidou  2 , Nikolaos Kavantzas  2 , Alkistis Pantopoulou  3 , Othon Michail  1 , Despina Perrea  3 , Gregory Kouraklis  1
Affiliations

The effect of autologous platelet-rich plasma on bronchial stump tissue granulation after pneumonectomy: experimental study

Eleftherios Spartalis et al. ISRN Surg. .

Abstract

Objectives. Recent advances in perioperative management, antibiotics, and surgical materials, including mechanical staplers, have decreased the operative risk of pulmonary resection. However, bronchopleural fistula can still occur in some instances, the occurrence often being lethal. This study investigated whether platelet-rich plasma (PRP) promotes granulation of the bronchial stump after pneumonectomy. Methods. Ten pigs were randomized into two groups: (A) control or non-PRP group (pneumonectomy) and (B) PRP group (pneumonectomy and PRP application). PRP was obtained by spinning down the animal's own blood and collecting the buffy coat containing platelets and white blood cells. Results. Increased platelet concentration triggered the healing process. The percentage of granulation tissue formed at the stumps was significantly higher in the PRP group of animals. This observation was confirmed when statistical analysis using Mann-Whitney U test was performed (P = 0.0268). Conclusions. PRP is easily produced with minimal basic equipment and is useful in accelerating granulation of the bronchial stump, although the timing and optimum number of applications in humans require further study. Autologous PRP is a safe, feasible, and reliable new healing promoter with potential therapeutic effects.

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Figures

Figure 1
Figure 1
(a) The left bronchus is divided with an endostapler. The black arrow shows the bronchial suture line. (b) The line is covered with a cylindrical clot of PRP applied vertically to the bronchial stump (white arrow).
Figure 2
Figure 2
Animal necropsy. The trachea and the right lung are harvested. The arrow shows the bronchial stump suture line.
Figure 3
Figure 3
Eosin/Haematoxylin stain. Cross-section of the bronchial stump (×20) showing minimal granulation tissue formation (arrows) in the non-PRP group (a) and abundant granulation tissue formation in the PRP group (b). Black arrow defines cartilage, while white arrow illustrates a suture (c). Granulation tissue consisted of chronic inflammatory cells (d), including foreign body giant cells (arrows) forming granulomas (×200).
Figure 4
Figure 4
(a) Percentages of granulation tissue (%) per transverse section taken (from lowest to highest for each group). (b) The percentage is significantly higher in PRP group (group B). All results with a two-sided P level ≤ 0.05 were considered statistically significant.
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