Emerging new therapies such as PRP can have an adjunctive role in a
standardized, quality treatment plan. The application of autologous PRP to soft
tissue healing has been a subject of great interest for much of the past two
decades. Multiple growth factors are present in high concentrations within PRP. Some
of the most important of these include PDGF, TGF-β, VEGF, EGF, and IGF. PDGF, TGF-β,
VEGF, and EGF have been shown to be increased 3 to 7 times in autologous PRP
[
22,
23]. Moreover, platelet concentrates contain many powerful
mitogenic and chemotactic growth factors, which regulate key processes involved in
tissue repair, including cell proliferation, chemotaxis, migration, cellular
differentiation, and extracellular matrix synthesis [
24,
25].
The results of this study appear to confirm observations from the basic
science of wound repair; in the large number of wounds, a positive change in wound
variables was seen following application of physiologically relevant concentration
of platelets. These findings are important because, while the PRP injection remain
the gold standard for determining treatment efficacy [
26]. Furthermore, we have revealed the benefits of topical
platelet-rich plasma gel for the treatment of the laterodorsal cutaneous wounds. Our
study have shown that wounds treated with PRP exhibited faster healing rates and
adequate granulation tissue formation when compared to wounds treated with
non-treated group. In addition, topical use of PRP has been shown to enhance
angiogenesis in the early stage of the repair process after open skin and
subsequently to promote wound healing.
According to the scope of the present study the effect of PRP in wound
healing indicated similar positive result of PRP in acceleration of epithelial
migration, the angiogenic response and tissue fill. In parallel, several clinical
studies, in both human and veterinary medicine, on the restoration of tissue
integrity have shown the positive role of platelets in natural wound healing
[
27‐
29]. When locally applied, platelets accelerate healing of normal
tissue and promote healing of impaired wounds [
30,
31].
Furthermore, Sharma and Maffulli have been reported that collagen is produced by
epitenon cells at the initial stage of the healing process, whereas endotenon cells
synthesized collagen later [
32].
However, these results is in agreement with those studies induced by Lee et al.,
that have noted acceleration of epithelialization in treatment of lower equine wound
with PRP [
33] and faster resolution in
inflammatory response. Moreover, Vaterio et al., have been shown acceleration in
skin reepithelialization by using PRP during fat grafting in patient who underwent
plastic surgery [
34]. In previous
study, Alsabaawe, Hom et al., have been suggested an increased of epithelialization
rate and regression of acute inflammatory process in PRP treated skin wounds in
rabbits during week 1 postoperative period compared to week 2 where there was no
statistical differences found in epithelial thickness and inflammation stage between
PRP treated wound and control. Also, they indicated that the epithelialization
returned to normal texture and improvement of wound healing in term of reducing the
inflammatory process [
35,
36]. On the other hand, Ahmad et al., (2012)
suggested that the PRP has the potential to enhance the healing of tissue at the
cellular level via the recruitment proliferation, and differentiation of cells
involved in tissue regeneration [
37]
Moreover, Gotterbarm et al., (2006) have been reported the PRP acts as a rich source
of autologous growth factors [
38]. Sun
et al., (2010) have been mentioned that, PRP is a very good clinical source for
osteochondral regeneration [
39]. On the
other hand, Shin et al., (2012) proved that PRP was effective in normal tissue
regeneration [
40]. These researches are
in agreement with our study. Moreover, recent studies demonstrated that
histopathological examinations are gold standards as diagnostic criteria in the
experimental animals on the different fields [
41‐
45].