title: Can tissue adhesives and platelet-rich plasma prevent pharyngocutaneous fistula formation?
abstract: OBJECTIVE
  One of the frequently encountered disorders of wound healing following laryngectomy is pharyngocutaneous fistula. However, although studies have been performed with the aim of prevention of pharyngocutaneous fistulae, there are very few studies with tissue adhesives and platelet-rich plasma. In this study, our aim was to investigate the histopathologic changes in wound healing caused by various tissue adhesives and platelet-rich plasma, together with their effects on prevention of pharyngocutaneous fistula.
  
  
  METHODS
  40 male rats were randomly divided into five groups: control, platelet-rich plasma, fibrin tissue adhesive, protein-based albumin glutaraldehyde and synthetic tissue adhesive groups. The pharyngotomy procedure was performed and was sutured. Except the control group, tissue adhesives and platelet-rich plasma were applied. Then, the skin was sutured. On the seventh day, the rats were sacrificed. The skin was opened and pharyngotomy site was assessed in terms of fistulae. The pharyngeal suture line was evaluated histopathologically by using Ehrlich Hunt scale.
  
  
  RESULTS
  Inflammatory infiltration was found to be higher in "platelet-rich plasma" group than "fibrin tissue adhesive" and "synthetic tissue adhesive" groups. The fibroblastic activity of "platelet-rich plasma", "fibrin tissue adhesive" and "protein-based albumin glutaraldehyde" groups was higher than the control group. The positive changes created by platelet-rich plasma and fibrin tissue adhesive at the histopathologic level were found together with no detected fistula. Among the study groups, there was no statistical difference for pharyngeal fistula development. This result may be obtained by the small number of animal experiments.
  
  
  CONCLUSIONS
  These results shed light on the suggestion that platelet-rich plasma and fibrin tissue adhesive can be used in clinical studies to prevent pharyngocutaneous fistula.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Adnan Menderes University School of Medicine, Aydın, Turkey. Electronic address: draylineryilmaz@gmail.com.
authors.forename: Aylin
authors.initials: A
authors.lastname: Eryılmaz
authors.affiliation: Department of Medical Pharmacology, Adnan Menderes University School of Medicine, Aydın, Turkey.
authors.forename: Buket
authors.initials: B
authors.lastname: Demirci
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Adnan Menderes University School of Medicine, Aydın, Turkey.
authors.forename: Ceren
authors.initials: C
authors.lastname: Gunel
authors.affiliation: Department of Medical Pathology, Adnan Menderes University School of Medicine, Aydın, Turkey.
authors.forename: Firuzan
authors.initials: F
authors.lastname: Kacar Doger
authors.affiliation: Pathology Department, Aydin State Hospital, Aydın, Turkey.
authors.forename: Ozden
authors.initials: O
authors.lastname: Yukselen
authors.affiliation: Department of Biostatistics, Adnan Menderes University School of Medicine, Aydın, Turkey.
authors.forename: Imran
authors.initials: I
authors.lastname: Kurt Omurlu
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Adnan Menderes University School of Medicine, Aydın, Turkey.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Basal
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Adnan Menderes University School of Medicine, Aydın, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Agdas
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Adnan Menderes University School of Medicine, Aydın, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Basak
mesh_terms: D000818:Animals; D017577:Cutaneous Fistula / Q000517:prevention & control*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology* / Q000627:therapeutic use; D005976:Glutaral / Q000494:pharmacology* / Q000627:therapeutic use; D007249:Inflammation; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D010608:Pharyngeal Diseases / Q000517:prevention & control*; D010614:Pharynx / Q000187:drug effects* / Q000473:pathology / Q000601:surgery; D053657:Platelet-Rich Plasma; D011183:Postoperative Complications; D051381:Rats; D014014:Tissue Adhesives / Q000494:pharmacology* / Q000627:therapeutic use; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D005976:Glutaral
keywords: Pharyngocutaneous fistula; Platelet-rich plasma; Tissue adhesives