Histological aspects of full-thickness skin grafts augmented with platelet-rich fibrin in rat model

Vol. 60 No. 2, 2019


Oliviu Nica, Dragos George Popa, Alexandru Florian Grecu, Eduard Mihai Ciuca, Marius Eugen Ciurea

Background and Objectives: The restoration of the damaged tissue commences very early with a regulated sequence of biochemical events set into motion to repair the damage. While the understanding of this entire process is still incomplete, it has been established that platelets play a decisive role not only in hemostasis, but also in the wound healing process, through an abundance of growth factors and other signaling cytokines modulating the inflammatory response. To this end, we attempted to evaluate the effect of a platelet-rich biomaterial - platelet-rich fibrin (PRF) - in the augmentation of full-thickness skin grafts (FTSGs). Materials and Methods: Skin defects were performed on the rats dorsum and covered with FTSGs. The test group wound bed was treated with PRF before the suture of the graft. Skin graft specimens were obtained from the control and test group rats for histological and immunohistochemical examination on the 21st postsurgical day. Our study included 40 male Wistar rats. Average thickness of epidermal cell layers was recorded for each wound site. The average fibroblast count was compared between the control and test (PRF-augmented FTSG) groups. Blood vessel count and vascular density - the blood vessels were identified under low-power microscopy. The prominent vascular areas were then scanned in higher-power fields; individual vessels were marked and counted by hand. Vascular density was calculated. Mean vascular count for each graft was then calculated. Results: The mean thickness of the epidermal layer was significantly higher and closer to the physiological epidermal thickness, in the test group than in the control group. The average fibroblast and fibrocyte count in the dermal layer in FTSGs augmented with PRF was higher than in the control group. We discovered a statistically insignificant increase in the blood vessel count and vascular density of the test group, compared to the control group. Conclusions: Our limited data supports the theory that the addition of PRF to FTSG recipient wound beds has the potential to improve graft take and regulate the proliferation of a thicker and more uniform epidermis, while decreasing healing time and dermal necrosis rates.

Corresponding author: Alexandru Florian Grecu, MD, PhD Student; e-mail: alexandrugrecu@yahoo.com

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