Abstract 18403: Enhanced Sternal Healing via Effect of Controlled Release and Spatial Retention of Platelet-Rich Plasma Impregnated in Biodegradable Gelatin Hydrogel
Introduction: Platelet-rich plasma (PRP) contains numerous growth factors and accelerates bone fracture healing. However, it is limited by the short half-life period during which it can promote regeneration.
Hypothesis: A controlled release of PRP will be more effective than conventional usage of PRP on the sternal healing.
Methods: A biodegradable gelatin hydrogel was used to control the release of PRP prepared from whole blood of Japanese white rabbits. After median sternotomy, 16 rabbits were randomized into four groups (n=4): control (Ctrl), 30 mg of gelatin hydrogel incorporating 300 μL of phosphate-buffered saline (gel), as well as that incorporating 300 μL of PRP (PRP+gel), and 300 μL of PRP solution (PRP). Before the sternum was closed, these solutions were implanted between sternum incisions. We compared sternal healing among the groups 7 days after surgical intervention with micro-computed tomography and histology.
Results: The resultant number of platelets (p<0.01) and concentrations of platelet-derived growth factor-BB, vascular endothelial growth factor, and transforming growth factor-β1 (p<0.05) were significantly higher in the PRP than in the whole blood. There were no significant differences (p>0.05) in the mineral density of cortical bones (656.9±46.2, 641.6±23.2, 629.3±100.8, and 691.1±60.6 mg/cm3 for Ctrl, gel, PRP, and PRP + gel, respectively). However, the controlled release of PRP increased the bone mineral density of sponge bones (382.7 mg/cm3) compared with those of the Ctrl, gel, and PRP groups (265.4±18.9, 325.6±41.4, and 285.4±31.5 mg/cm3, respectively, p<0.01). Histological analysis of the PRP+gel group indicated possible invasion of fibrous tissue into the separated sternal space and no change in the vascular density around the sternum. Apparent sternal dehiscence was observed in the Ctrl, gel, and PRP groups by radiography.
Conclusions: Controlled release of PRP is markedly effective in promoting sternal healing at an early phase. It is possible that this novel therapy prevents complications, such as deep sternal wound infection, and causes early postoperative ambulation after thoracic surgery. Further studies are needed to elucidate the mechanism for clinical use.
Author Disclosures: M. Shibata: None. J. Kurita: None. Y. Miyagi: None. T. Nitta: None.
- © 2016 by American Heart Association, Inc.