Does Platelet-Rich Plasma (PRP) Improve Colonic Anastomotic Healing in Rats Undergoing Cisplatin-Paclitaxel-Based HIPEC?

Abstract

Hyperthermic intraperitoneal chemotherapy (HIPEC) causes delays in wound healing. Platelet-rich plasma (PRP) gel has been shown to be effective in facilitating wound healing. We examined the effect of PRP gel on the healing of colonic anastomosis in rats that received HIPEC. Twenty-four rats were subdivided into three groups. In group 1, the rats only underwent colonic anastomosis. In group 2, the rats underwent colonic anastomosis and cisplatin-paclitaxel-based HIPEC. In group 3, the rats underwent colonic anastomosis and cisplatin-paclitaxel-based HIPEC. Afterwards, PRP gel was administered to the colonic anastomosis region. The rats were sacrificed on the 7th postoperative day, the anastomotic bursting pressure (ABP) was recorded, and tissue samples were taken from the anastomotic line. Compared to that in group 2, ABP was higher in group 1 and group 3 (p= 0.002 and 0.048, respectively). Tissue hydroxyproline levels were higher in group 1 (p= 0.001) and group 3 (p = 0.043) than in group 2. Histopathological evaluation revealed a significant decrease in fibroblast activity in group 2 compared to that in group 1 (p= 0.006), with no significant difference between group 3 and group 1 (p= 0.585). Collagen accumulation was significantly lower in group 2 than in group 1 and group 3 (p= 0.001 and p= 0.019, respectively). PRP gel application may aid wound healing by increasing colon ABP, tissue fibroblast activity and collagen accumulation; therefore, its use may reduce the cytotoxic effects of HIPEC and facilitate the anastomotic wound healing process.