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CC BY 4.0 · Arch Plast Surg
DOI: 10.1055/a-2317-4520
Original Article

Preconditioning Local Injection of Activated Platelet-Rich Plasma Increases Angiogenesis, VEGF Levels, and Viability of Modified McFarlane Flap in Diabetes-Induced Rats

Jenisa Amanda Sandiarini Kamayana
1   Plastic, Reconstructive and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Udayana University, Denpasar, Indonesia (Ringgold ID: RIN95322)
,
Agus Roy Rusly Hariantana Hamid
1   Plastic, Reconstructive and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Udayana University, Denpasar, Indonesia (Ringgold ID: RIN95322)
,
Tjokorda Gde Bagus Mahadewa
2   Department of Neurosurgery, Faculty of Medicine, Udayana University, Denpasar, Indonesia (Ringgold ID: RIN95322)
,
I Gusti Putu Hendra Sanjaya
3   Plastic, Reconstructive and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Udayana University, Denpasar, Indonesia (Ringgold ID: RIN95322)
,
I Made Darmajaya
4   Paediatric Surgery Division, Department of Surgery, Faculty of Medicine, Udayana University, Denpasar, Indonesia (Ringgold ID: RIN95322)
,
I Gusti Ayu Sri Mahendra Dewi
5   Anatomical Pathology Department, Faculty of Medicine, Udayana University, Denpasar, Indonesia (Ringgold ID: RIN95322)
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Background The risk of flap necrosis in tissue reconstruction surgery is elevated in patients with vascular disorders, such as diabetes mellitus. Chronic hyperglycaemia causes endothelial cell dysfunction and increases inflammatory process, causing vascular insufficiency. Platelet-rich plasma (PRP) contains high levels of platelets, growth factors and fibrinogens. Its regenerative properties spark interest in supporting flap survival in relation to diabetic complications. Methods Thirty Wistar rats were divided into three groups. The first group included diabetic rats without PRP injection, which underwent flap procedure. The second group included diabetes-induced rats receiving PRP subcutaneous injection one day prior to flap procedure. The third group included non-diabetic rats receiving PRP injection one day prior to flap procedure. Flap tissue samples were taken on the seventh day to measure VEGF levels using enzyme-linked immunosorbent assay (ELISA) method; angiogenesis and collagen density were measured from histopathology examination, and flap viability was analysed using digital measurements. Results Analysis showed that flap viability, angiogenesis and VEGF levels were significantly higher in the PRP-injected diabetic rats compared to diabetic rats that did not receive PRP. The levels of VEGF, angiogenesis and viability of flaps in diabetic rats given PRP did not differ significantly compared to non-diabetic rats that received PRP. Conclusion Flap preconditioning through local injection of activated PRP enhances flap viability, VEGF levels and angiogenesis, in random skin flaps in diabetic rats, to the level where it does not differ significantly to non-diabetic rats that were given PRP. Keywords. Platelet-rich plasma, diabetes mellitus, VEGF, angiogenesis, random skin flap



Publikationsverlauf

Eingereicht: 21. Oktober 2023

Angenommen nach Revision: 28. April 2024

Accepted Manuscript online:
30. April 2024

© . The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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