Platelet Rich Plasma Enhances Mechanical Strength of Strattice in Rat Model of Ventral Hernia Repair.

Incisional hernia continues to be a common complication of hernia repair in spite of the development of various synthetic and bio-synthetic repair materials. Poor long-term mechanical strength, leading to high recurrence rates, has limited the use of acellular dermal matrices (ADM) in ventral hernia repair (VHR). Biologically-derived meshes have been an area of increasing interest, but these materials bring the risk of more aggressive immune response and fibrosis in addition to the mechanical failures suffered by synthetic materials. Platelet rich plasma (PRP), a growth factor rich autologous blood product, has been shown to improve early neovascularization, tissue deposition, and to decrease rates of recurrence. Here, we demonstrate that PRP promotes release of growth factors SDF-1, TGFβ, and PDGF in a dose-dependent manner. Additionally, we utilize an aortic ring angiogenesis assay to demonstrate that show that PRP promotes angiogenesis in vitro. A rat model of ventral hernia repair using StratticeTM ADM demonstrates similar findings in vivo, corresponding with increased expression of VEGF and COL1a. Finally, we show that the molecular and cellular activity initiated by platelet-rich plasma results in increased mechanical stiffness of the hernia repair mesh over time. Collectively, these data represent an important step in demonstrating the utility and the mechanism of platelet-derived plasma in biomaterial-aided wound healing and provide promising pre-clinical data that suggest such materials may improve surgical outcomes. This article is protected by copyright. All rights reserved.