Effects of platelet-rich plasma on cutaneous flap healing in rabbits: a pilot comparative experimental study with adipose tissue

Random-pattern cutaneous flaps are a mainstay in reconstructive surgery (especially in the head and neck region), yet their distal viability is often compromised by ischemia. Platelet-rich plasma (PRP) is a concentration of autologous platelets rich in growth factors that stimulate angiogenesis, collagen deposition, and overall wound healing. Autologous adipose tissue, an abundant source of mesenchymal stem cells, has also been proposed to enhance neovascularization and tissue regeneration. This study aimed to compare the effects of PRP versus adipose tissue on the healing and survival of dorsal random-pattern cutaneous flaps in rabbits. Nine adult male New Zealand White rabbits underwent surgery, each having three dorsal skin flaps raised on their backs. Each rabbit served as its own control: one flap received no treatment, the second flap received autologous PRP injections, and the third flap received autologous adipose tissue injections. Clinical evaluations, including flap survival percentage, and histological assessments (necrosis, fibrosis, collagen deposition, vascularity, inflammation) were conducted on postoperative Days 7, 14, and 21. PRP-treated flaps showed directionally more favorable flap survival and histologic remodeling than adipose-treated and untreated flaps, with statistically significant between-group differences observed for collagen/fibrosis and vascular proliferation at Day 21. Necrosis scores were numerically lower in the PRP group, although these differences did not reach statistical significance. Adipose-treated flaps showed intermediate findings. PRP was associated with more favorable flap healing and histologic remodeling than adipose tissue injection or no adjunctive treatment in this rabbit model. These findings should be interpreted as preliminary and hypothesis-generating, and further controlled studies are needed to clarify comparative efficacy and clinical relevance.