Effect of the platelet-rich plasma covering of polypropylene mesh on oxidative stress, inflammation, and adhesions.

INTRODUCTION AND HYPOTHESIS: Polypropylene mesh (PPM) is often used for urogynecological repair; however, it can cause complications. An approach to reduce complications is to coat PPM with anti-inflammatory and wound-healing molecules. Platelet-rich plasma (PRP) is inexpensive and improves wound healing. Therefore, we evaluated whether covering PPM with PRP could reduce inflammation, adhesion, and oxidative stress (OS) in rabbits.

METHODS: The primary objective was to evaluate OS, and the secondary objectives were to evaluate inflammation and adhesion. PRP-coated PPM was implanted on the right side of the abdominal cavity of 12 female New Zealand rabbits, in the interface between the hypodermis and peritoneum. An uncoverated PPM was implanted in the other side. Twelve rabbits served as the sham group; all animals were euthanized after 30 or 60 days. Inflammatory parameters were myeloperoxidase (MPO) and N-acetylglucosaminidase (NAG) activities. OS was evaluated by measuring the ferric-reducing antioxidant power, the free-radical-reducing ability of 3-ethylbenzothiazoline-6-sulfonic acid [2,2'-azino-bis (ABTS)], reduced glutathione levels, and superoxide anion production. Adhesion was measured using tenacity and Diamond scales (the latter of which grades adhesions according to their extent) Inflammation and OS were analyzed by analysis of variance (ANOVA), followed by Tukey's test. The Mann-Whitney test was used to evaluate adhesions, and analysis of the sham group was conducted using Kruskal-Wallis test.

RESULTS: No significant differences were observed in parameters of adhesions. After 60 days, PRP-coverated PPM presented a decrease in MPO and NAG activities. Furthermore, decreased OS and increased antioxidant levels were observed in PRP-coverated PPM samples.

CONCLUSIONS: The reduction of OS and inflammatory responses indicates that PRP-covered PPM is a promising therapeutic approach.