Comparative Evaluation of Leukocyte- and Platelet-Rich Plasma (L-PRP) and Pure Platelet-Rich Plasma (P-PRP) for the Prevention of Adhesion Formation in a Rat Horn Model

Objectives: To compare the effects of leukocyte- and platelet-rich plasma (L-PRP) and pure platelet-rich plasma (P-PRP), both among themselves and with the control group, in preventing intra-abdominal adhesions in an experimental rat model study. Materials and Methods: 34 Sprague-Dawley rats were randomized and divided into the control group (n=8), L-PRP (n=8), and P-PRP (n=8) treatment groups. The fourth group was used only for PRP preparation (5 rats for L-PRP and 5 rats for P-PRP) and was not included in the outcome analysis. All of the rats were operated on by the same two surgeons under general anesthesia for the uterine horn adhesion modeling. Apart from the control group, 1 mL of L-PRP and P-PRP solutions prepared for the other two treatment groups were applied to the lesion. Postoperative adhesion evaluation was performed on the 14th postoperative day. Adhesions were evaluated both macroscopically (presence, severity, and degree of adhesion) and histopathologically (levels of inflammation and fibrosis), and the evaluation was blinded by two similar surgeons. Results: One rat was lost during the study in each treatment group. There was a statistically significant difference in terms of the extent of adhesions among the groups (P = 0.025), the tenacity of the adhesions (P = 0.045), and total adhesion scores (7.13±2.7, 3.86±1.5, and 6.71±2.1; control, L-PRP, and P-PRP, respectively, P = 0.028). This difference was due to Group 2 during binary comparisons. However, the statistical difference between the groups after Bonferroni correction disappeared, apart from the tenacity of adhesions category. In the tenacity of adhesion category, the difference was only between the control group and L-PRP (12.5% in the gentle traction separation control group vs. 85.7% in L-PRP; P = 0.005). On histopathological examination, there was no difference between the groups in inflammation or fibrosis. Conclusions: In the experimental rat uterine horn adhesion modeling, neither L-PRP nor P-PRP was effective in preventing postoperative adhesion formation. However, the adhesion formed in the L-PRP group was more readily separated by gentle traction than in both the control and P-PRP groups.