Turkderm-Turk Arch Dermatol Venereol. 2018; 52(2): 44-50 | DOI: 10.4274/turkderm.42966

Clinical and histopathological evaluation of the effects of platelet rich plasma, platelet poor plasma and topical serum physiologic treatment on wound healing caused by radiofrequency electrosurgery in rats

Aslý Duran¹, Sirin Yasar², Sema Aytekin², Pembegul Gunes³, Riza Adaleti⁴, Alpay Duran^5
1Þanlýurfa Balýklýgöl State Hospital, Clinic of Dermatology, Þanlýurfa, Turkey
²University of Health Sciences, Haydarpaþa Numune Training and Research Hospital, Clinic of Dermatology, Ýstanbul, Turkey
³University of Health Sciences, Haydarpaþa Numune Training and Research Hospital, Clinic of Pathology, Istanbul Turkey
⁴University of Health Sciences, Haydarpaþa Numune Training and Research Hospital, Clinic of Microbiology, Ýstanbul, Turkey
⁵Þanlýurfa Mehmet Akif Ýnan Training and Research Hospital, Clinic of Plastic and Reconstructive Surgery, Þanlýurfa, Turkey

Background and Design: The aim of our study was to histopathologically evaluate the effects of platelet rich plasma (PRP) and platelet poor plasma (PPP) treatment in wound healing process in rats with partial thickness wound.
Materials and Methods: Rats were divided into three groups as topical serum physiologic (SP) (group 1, n=9), PPP (group 2, n=9), and PRP (group 3, n=9). Wound model was created by radiofrequency-electrosurgery. Each group was treated once with SP, PRP and PPP. Four-millimeter punch biopsies were collected from each rat on the 4th, 7th, 14th and 21st days. One rat in each of the PRP and SP groups was lost before the study was completed.
Results: In our study, we observed that PRP significantly increased granulation tissue formation and angiogenesis after the fourth day of treatment. PPP increased granulation tissue formation and angiogenesis to a lesser extent than PRP but to a greater extent compared to SP. An increase in fibroblast density was observed in PRP and PPP groups compared to that in SP group on the 7th, 14th and 21st days. Epidermal detachment was significantly increased in the PRP group compared to PPP group on the 4th day. On 7th and 14th days, a higher increase was observed in the PPP and PRP groups compared to SP group. On the 21st day, epidermal detachment was observed in all the three groups. In terms of collagen synthesis levels, a significant increase was observed in PPP group compared to SP group on the 4th day and a significant increase was observed in PRP group compared to PPP group on the 21st day. There was no significant difference between groups on the 7th and 14th days.
Conclusion: In our study, we observed that both PRP and PPP stimulate and increase angiogenesis, reepithelization, granulation tissue and collagen synthesis compared to SP. We observed that there was a significant increase in angiogenesis and granulation tissue formation in PRP group compared to PPP group.

Keywords: PRP, PPP, SP, wound healing, angiogenesis, granulation, fibrosis, epithelization

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Sýçanlarda radyofrekans elektrocerrahi ile oluþturulmuþ yarada trombositten zengin plazma, trombositten fakir plazma ve topikal serum fizyolojik tedavisinin yara iyileþmesine etkisinin klinik ve histopatolojik olarak deðerlendirilmesi

Aslý Duran¹, Sirin Yasar², Sema Aytekin², Pembegul Gunes³, Riza Adaleti⁴, Alpay Duran^5
1Þanlýurfa Balýklýgöl Devlet Hastanesi, Dermatoloji Kliniði, Þanlýurfa, Türkiye
²Haydarpaþa Numune Eðitim ve Araþtýrma Hastanesi, Dermatoloji Kliniði, Ýstanbul, Türkiye
³Haydarpaþa Numune Eðitim ve Araþtýrma Hastanesi, Patoloji Kliniði, Ýstanbul, Türkiye
⁴Haydarpaþa Numune Eðitim ve Araþtýrma Hastanesi, Mikrobiyoloji Kliniði, Ýstanbul, Türkiye
⁵Mehmet Akif Ýnan Eitim ve Araþtýrma Hastanesi, Plastik, Rekonstrüktif ve Estetik Cerrahi Kliniði, Þanlýurfa, Türkiye

Amaç: Çalýþmamýzýn amacý trombositten zengin plazma (PRP) ve trombositten fakir plazmanýn (PPP) kýsmi kalýnlýklý yara oluþturulmuþ ratlarda yara yeri iyileþmesinde oluþturacaðý etkilerin histopatolojik olarak deðerlendirilmesidir.
Gereç ve Yöntem: Sýçanlar, serum fizyolojik (SF) (grup 1, n=9), PPP (grup 2, n=9), PRP (grup 3, n=9) grubu olacak þekilde 3 gruba ayrýldý. Radyofrekans-elektrocerrahi yöntemi ile yara modeli oluþturuldu. Her bir gruba SF, PRP, PPP uygulamasý bir kez uygulandý. Her sýçandan, iþlemi takip eden 4. 7. 14. ve 21. günlerde 4 mm punch biyopsiler alýndý. SF ve PRP uygulanan deney gruplarýnda birer sýçan çalýþma sürerken kaybedilmiþtir.
Bulgular: Çalýþmamýzda 4. gün sonrasý PRP’nin SF ve PPP grubuna göre granülasyon dokusu ve anjiogenezi anlamlý düzeyde arttýrdýðý sonucuna ulaþýldý. Bununla birlikte PPP’nin de PRP’den daha az oranda olmakla birlikte anjogenez ve granülasyon dokusu oluþumunu SF grubuna göre anlamlý düzeyde arttýrdýðý sonucuna saptandý. Fibroblast yoðunluklarý deðerlendirildiðinde 7. 14. ve 21. günlerde PRP ve PPP gruplarýnda SF grubuna oranla fibroblast yoðunluðunda anlamlý bir artýþ belirlendi. Çalýþmamýzda epidermal ayrýþmayý PRP grubunun 4. günde PPP grubuna göre anlamlý düzeyde arttýrdýðý sonucuna ulaþýldý. Yedinci ve on dördüncü günlerde PPP ve PRP grubunda SF gruplarýna oranla anlamlý artýþ saðlandý. Yirmi birinci günde ise her üç grupta epidermal ayrýþma gözlendi. Çalýþmamýzda kollajen sentez düzeyleri deðerlendirildiðinde yapýlan ikili karþýlaþtýrmalarda 4. günde PPP grubunda SF grubuna göre, 21. günde ise PRP grubunun PPP grubuna oranla anlamlý düzeyde arttýrdýðý saptanýrken 7. ve 14. günlerde gruplar arasý anlamlý fark saptanmadý.
Sonuç: Çalýþmamýzda gerek PRP grubunun, gerekse PPP grubunun, kontrol grubuna göre anjiyogenez, reeepitelizasyon, granülasyon dokusu ve kollajen oluþumunu anlamlý düzeyde daha fazla uyardýðý ve arttýrdýðý saptandý. Özellikle PRP grubunda anjiyogenez ve granülasyon dokusu oluþumunun PPP grubuna oranla daha anlamlý düzeyde artýþ gösterdiði sonucuna ulaþýldý.

Anahtar Kelimeler: TZP, TFP, SF, yara iyileþmesi, anjiyogenez, granülasyon, fibrozis, epitelizasyon

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