The effect of PRP-therapy on the development of impaired bile excretion under the influence of mechanical damage to the skin, skeletal trauma complicated by acute blood loss, and combined trauma
Authors: Smahlii Z. 
Published: July 2022

Introduction. Traumatism is considered to be one of the most topical problems. Its structure is predominated by multiple and combined traumas, which lead to organ and tissue failure remote from the site of the initial trauma. Mechanical damage to the skin is frequently experienced by victims as the result of increase in the number of traffic accidents and combat injuries. However, the hepatic function in the presence of mechanical skin damage is insufficiently studied. There is a paucity of scientific evidence attesting to the efficacy of platelet-rich plasma grafts (PRP - therapy), which play an important role in promoting the healing processes of damaged body tissues.

Objective: to establish the effect of PRP-therapy on the development of impaired bile excretion under the influence of mechanical damage to the skin, skeletal trauma complicated by acute blood loss and combined trauma.

Materials and methods. The experimental studies were conducted on 126 nonlinear white male rats weighing 180-200 g, which were divided into five groups: the control and four experimental ones. The control group consisted solely of the intact animals exposed to general anesthesia. In the first experimental group, the animals were simulated a mechanical damage to the skin, the rats of the second experimental group were subjected to a skeletal trauma complicated by acute blood loss, the third experimental group had both these lesions combined. In the fourth experimental group, the PRP-therapy was applied using allogeneic platelet-rich plasma injections to the animals with combined trauma. After 3, 7, 14, 21 and 28 days of the posttraumatic period, the common bile duct was catheterized in the control and experimental groups, the bile was collected and the rate of bile excretion was determined.

The results and discussion. The conducted studies have evidenced that mechanical damage to the skin, skeletal trauma complicated by acute blood loss, and the combined trauma model were accompanied by a significant decrease in bile excretion rate, indicating the development of secondary liver failure and the deduced functional capacity of the liver. Consequently, the isolated damage to skin has systemic effects on the body and can aggravate impairments caused by skeletal trauma complicated by acute blood loss. The administration of the PRP-therapy injections to rats with combined trauma model resulted in less severe impairments of bile excretion compared to the animals without corrective medication, which was particularly noticeable in late manifestations of traumatic disease after 21 and 28 days. Hence, the PRP-therapy appears to be a promising medication in the presence of combined trauma in terms of decreasing the risk associated with the development of multiple organ failure, which substantiates the pertinence of further depth-in study.

Conclusions. Mechanical damage to the skin results in an impaired hepatic function in rats, which is manifested by a diminished bile flow. An additional infliction of mechanical damage to the skin in the presence of skeletal trauma complicated by acute blood loss exacerbates the impairment of bile excretion with a maximum of abnormalities occurred after 7 and 21 days of the posttraumatic period. The administration of the PRP-therapy injections in the background of combined trauma model is accompanied by less abnormal rate of bile excretion, which is statistically significant after 21 and 28 days of the experimental period, as compared to the animals without corrective medication.