Предоперационное применение плазмы, обогащенной тромбоцитами, в комбинации с сосудисто-стромальной фракцией в лечении длительно незаживающих ран

Adipose tissue and platelet-rich plasma (PRP) have gained significant attention in regenerative medicine and plastic surgery due to their potential in tissue repair and wound healing. This review aimed to analyze the biological properties of adipose tissue, lipofilling techniques, and the role of PRP in enhancing fat graft survival and tissue regeneration. A comprehensive review of the literature was carried out to evaluate the cellular composition, regenerative mechanisms, and clinical applications of adipose-derived therapies and PRP. Adipose tissue contains multipotent stem cells that contribute to angiogenesis, immunomodulation, and tissue remodeling. PRP enhances fat graft retention by promoting vascularization and reducing inflammatory responses. The combined use of PRP and adipose tissue has shown promising outcomes in wound healing, plastic surgery, and reconstructive procedures. The integration of adipose tissue derivatives and PRP holds significant potential for improving surgical outcomes. However, further research is needed to standardize protocols, optimize therapeutic strategies, and ensure reproducible clinical benefits.

Background: Optimal healing of surgical skin wounds remains a critical issue in modern surgery. This study evaluated the effect of preoperative administration (before wound creation) of platelet-rich plasma (PRP) and stromal vascular fraction (SVF) on wound healing in a rabbit full-thickness excisional skin wound model. Methods: Forty animals were randomized into five groups: control (no treatment), 0.9% NaCl, SVF, PRP, and PRP + SVF. Biological agents were injected intradermally 24 h before standardized 2-cm excisional wounds were created. Histological, morphometric, IHC and contraction indices (SCI, DCI, WCI) were assessed at days 7, 14, and 30. Results: Preoperative administration of PRP + SVF significantly enhanced cutaneous wound repair, with early re-epithelialization evident by day 7 and complete epithelial restoration by day 14 compared with the control group. Histomorphometric analysis revealed that the PRP + SVF group demonstrated the highest angiogenic response on day 7 (median 24 vs. 12 in the control group, p = 0.027), the greatest regenerative tissue thickness on day 14 (84.5% vs. 62.5%, p = 0.021), and the highest extracellular matrix remodeling index on day 30 (0.655 vs. 0.404), accompanied by regeneration of skin appendages (median score 3 vs. 1 in the control group, p = 0.005). Conclusions: These findings demonstrate that preoperative administration of PRP combined with SVF improves the histological and histomorphometric outcomes of cutaneous wound healing. These preliminary findings provide a rationale for further experimental studies to validate and optimize this approach, to elucidate the underlying mechanisms, and to clarify the specific contribution of preoperative tissue conditioning.