The Combined Leukocyte-Platelet Rich Fibrin and Chitosan Ameliorate Healing of Colon Anastomosis in a Model of Rabbit

Abstract

Intestinal anastomosis is among the most regularly performed operations in gastrointestinal surgery. However, poor wound healing at anastomotic locations, particularly in the colon, leads to severe complications, increased need for reoperation, prolonged hospital admissions, and greater mortality rates. This study aims to investigate the effect of leukocyte- and platelet-rich fibrin (L-PRF) coupled with chitosan (CH) on the healing of colonic anastomoses in rabbits. A full colonic transection followed by anastomosis was done in 36 rabbits. In the control group, no adjunctive substance was applied. In the treatment group, two L-PRF matrices were wrapped and fastened around the anastomosis site, followed by careful application of 1 mL of 1% CH solution. Healing was examined clinically, histopathologically, and immunohistochemically on postoperative days 7, 14, and 28. Statistical analysis demonstrated significant improvements in the treatment group compared to the control group, including better radiographic stenosis scores, higher mechanical bursting pressures, and superior histological healing scores (p < 0.01) at all examined time points. We conclude that L-PRF combined with CH significantly enhanced colonic anastomotic healing in rabbits, as evidenced by increased submucosal collagen deposition, accelerated mucosal re-epithelialization, enhanced angiogenesis, reduced adhesion formation, and decreased anastomotic stenosis compared to controls.