Platelet-rich plasma improves biologic mesh incorporation in ventral hernia repair: Study

USA: Findings from a recent study suggest that platelet-rich plasma (PRP) reduces inflammation which may be useful for the incorporation of the acellular dermal matrix (ADM) in ventral hernia repair (VHR). Also, PRP decreases multinucleated giant cells in a dose-dependent manner. The study findings appear in the Journal of Tissue Engineering and Regenerative Medicine.

Previous studies have shown, PRP reduces inflammation and improves incorporation in VHR with ADM. Platelets concentration in PRP varies in clinical studies and an ideal concentration still needs to be defined. The effects of varying concentrations of PRP on ADM incorporation and inflammatory cell infiltration in a rat model of VHR. In a recent study, Raquel Araujo-Gutierrez, Department of Cardiovascular Science, Houston, Texas, USA, and colleagues hypothesized that increasing PRP concentration would improve incorporation, decrease CD8+ and multinucleated giant cell (MNGC) infiltrate.

Lewis rats underwent ventral hernia creation and repair 30 days later with porcine non-crosslinked ADM. PRP was applied to the mesh prior to skin closure at concentrations of 1x104plt/μl (PRP-LOW), 1x106plt/μl (PRP-MID), or 1x107plt/μl (PRP-HIGH) and tissue harvested at 2 and 4wks.

The researchers assessed tissue deposition, cellularization, and mesh thickness using H&E and Massons trichrome, and neovascularization with VVG staining, to establish the relationship of PRP concentration to metrics of incorporation. To establish the relationship of inflammatory cell infiltration in response to PRP concentration, MNGC, and CD8+ T-cell infiltration were quantified. Lymphocyte infiltration was assessed using immunohistochemical staining for CD8.