The Efficacy of Platelet-rich Plasma Gel and Topical Estradiol Alone or in Combination on Healing of Full-thickness Wounds
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Abstract: This randomized study was designed to establish the efficacy of platelet-rich plasma (PRP) gel and topical estradiol alone, or in combination, on healing of full-thickness wounds created on the trunk of rabbits. Fifteen New Zealand white female rabbits and 60 wounds were studied. Four 2.25-cm² full-thickness wounds were created using a template and treatments including a sterile saline solution that were assigned randomly to the wounds. Wounds were bandaged, dressed intermittently, and assessed by wound measurements and a collection of samples at 7, 14, and 21 days to evaluate healing. Variables of interest were hydroxyproline concentration and scored gross and microscopic morphologic characteristics reflective of wound healing. PRP gel + estradiol-treated wounds completely healed faster than wounds given other treatments. Granulation tissue growth to the skin level was faster (P < 0.05) in the PRP gel + estradiol group than the other groups. Only the PRP gel + estradiol group had a significantly lower collagen level than the sterile saline solutions on day 7 (P < 0.05). The PRP gel + estradiol group and estradiol group led to an increase in angiogenesis on day 14 (P < 0.05). Complete epithelization was observed only in the PRP gel + estradiol group compared with the other groups on day 7. PRP gel + estradiol-treatment enhanced healing in full-thickness wounds by reducing the contraction rate with a trend toward accelerating both epithelial migration and the angiogenic response.
Address correspondence to:
Ozlem H. Nisbet, DVM, PhD
Department of Surgery, Faculty of Veterinary Medicine
Ondokuz Mayis University
The primary goal of wound care is to achieve rapid and functional healing with a cosmetic scar.1 Wound healing involves a series of events (ie, clotting, inflammation, organization of granulation tissue, epithelization, and tissue restoration). These events are ensued by stimulation and organization of cellular activities through the interaction of the signals formed by cytokines and growth factors.1–3 Following injury, various growth factors such as platelet-derived growth factor (PDGF), transforming growth factor beta and alpha (TGF-β and TGF-α), platelet-derived endothelial cell growth hormone (PDEGH), fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF), interleukin l (IL-1), interleukin 2 (IL-2), and platelet-activating factor 4 (PAF-4), are released.1,3–8 These factors play a particular role in restoring tissue (re-epithelization and neovascularization), synthesizing the extracellular matrix, and recruiting mesenchymal cells.3 PRP is a concentrated thrombocyte product that has been used in clinical trials to hasten wound healing.2,5
Estradiol receptors are known to exist in cells involved in the healing process such as macrophages, fibroblasts, endothelium, and in the cytoplasm and/or nucleus of various cells in the dermis,9 and are reported to indirectly influence the proliferative phase of the wound healing by increasing the production of growth factors.10–12
To our knowledge, there was no study on the effect of PRP gel and estradiol combination on wound healing in the literature.
The purpose of the present study was to investigate the clinical, biochemical, and histopathological effects of these substances used either alone or in combination on wounds with substantial loss.
Materials and Methods
Study population. A total of 15, 6-month-old, New Zealand white female rabbits (2500 ± 300 g body weight), which had been supplied by the Surgical Research Center at Ondokuz Mayis University (Samsun, Turkey) were used in the study.
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