Platelet-Rich Plasma Gel as a Local Hemostatic Agent in Microvascular Anastomosis: An Experimental Study in a Rat Model

Background: Microvascular anastomosis in rats serves as an essential training model for surgeons to master microvascular anastomosis, often involving significant bleeding after clamp release due to the high blood pressure (120–140 mmHg) in femoral arteries relative to the vessel size. Traditionally it is addressed by use of hemostatic measures such as local tissue wrap or synthetic hemostatic agents. This study explores the use of autologous platelet-rich plasma (PRP) gel as a hemostatic agent during microvascular anastomosis. Aim: To evaluate the effectiveness of PRP gel as a local hemostatic agent in a rat femoral vessel microvascular anastomosis model. Materials and Methods: Twenty male Sprague Dawley rats underwent end-to-side microvascular anastomosis, with 10 rats in the PRP treatment group and 10 in the control group. PRP was prepared by centrifuging blood collected from the femoral artery of the rat. PRP gel, activated with calcium gluconate, was applied at the anastomosis site in the study group, while the control group received a local tissue wrap just before clamp release. Bleeding, vessel patency, and post-surgical outcomes were assessed. Results: The PRP group exhibited significantly reduced bleeding compared to the control group (p = 0.000045,Chi-square test), with 7 out of 10 anastomoses showing no bleeding. In contrast, all control group anastomoses required hemostatic measures. Both groups had 100% patency postoperatively, both in the immediate period and after 2 weeks. After 14 days, the PRP group showed signs of new vessel formation in 3 rats. Conclusion: PRP gel is an effective hemostatic agent in microvascular anastomosis, reducing bleeding and the need for additional hemostatic measures while maintaining vessel patency. This study is among the first to evaluate PRP as a hemostatic agent in microvascular anastomosis, to the best of our knowledge, with promising results for enhancing surgical outcomes. Further studies are required to explore its potential clinical application in human microvascular surgery.