Influence of Injectable Platelet-Rich Fibrin on ex vivo Leak Pressure of Canine Enterotomy

Injectable platelet rich fibrin, the latest innovation among platelet concentrates is obtained by centrifugation of whole blood without any anticoagulants. The initially liquid product is later converted into gel form due to conversion of fibrinogen into fibrin. This feature allows it to be used in injectable form or as topical spray. Incisional dehiscence and leakage is a potentially fatal postoperative complication of enterotomy. This study was conducted to investigate whether injectable platelet rich fibrin could be used as suture line reinforcement method in canine enterotomy. It was hypothesized that topically applied injectable platelet rich fibrin could increase the leakage pressure of enterotomy incisions. A total of 28 enterotomy incisions measuring 3 cm in length were created on the antimesenteric border of jejunum in canine cadaveric samples. The incisions were sutured with simple interrupted or simple continuous patterns and the suture line was reinforced by topical injectable platelet rich fibrin in treatment groups. Leak testing was conducted immediately and 15 minutes after suture placement in control and treatment samples respectively and initial leakage pressure and maximum intraluminal pressure was recorded along with leakage location. Although statistically insignificant, application of injectable platelet rich fibrin in the simple continuous treatment group increased the mean initial leakage pressure in comparison to simple continuous control group (15 ± 7.228 vs. 11.67 ± 26.17). Mean maximum intraluminal pressure was increased in both simple interrupted (46.29 ± 30.53 vs. 39 ± 34.54) and simple continuous (47.78 ± 9.497 vs. 35.67 ± 31.46) treatment groups in comparison to their respective control groups. Leakage was observed from the incision line and from the needle holes outside the incision line in simple interrupted and simple continuous sutured incisions respectively. Although the results indicated the feasibility of using this method but in vivo investigations are required to determine whether it could be used in clinical cases.