Objectives. Recent advances in perioperative management, antibiotics, and surgical materials, including mechanical staplers, have decreased the operative risk of pulmonary resection. However, bronchopleural fistula can still occur in some instances, the occurrence often being lethal. This study investigated whether platelet-rich plasma (PRP) promotes granulation of the bronchial stump after pneumonectomy. Methods. Ten pigs were randomized into two groups: (A) control or non-PRP group (pneumonectomy) and (B) PRP group (pneumonectomy and PRP application). PRP was obtained by spinning down the animal’s own blood and collecting the buffy coat containing platelets and white blood cells. Results. Increased platelet concentration triggered the healing process. The percentage of granulation tissue formed at the stumps was significantly higher in the PRP group of animals. This observation was confirmed when statistical analysis using Mann-Whitney U test was performed ( ). Conclusions. PRP is easily produced with minimal basic equipment and is useful in accelerating granulation of the bronchial stump, although the timing and optimum number of applications in humans require further study. Autologous PRP is a safe, feasible, and reliable new healing promoter with potential therapeutic effects. 1. Introduction Since the first pneumonectomy performed by Graham and Singer in 1933 [1], the mortality of this procedure has decreased progressively [2]. The improvements in the surgical technique have contributed significantly to this decrease. Although parallel declines in the incidence of bronchopleural fistula (BPF) have been reported, this complication remains a major concern for the thoracic surgeon with associated high morbidity and mortality rates [3]. Most bronchial stump fistulas appear early after pneumonectomy [3]. One of the promising but clinically challenging areas of therapeutic advances involves the topical application of growth factors to enhance normal healing. A new strategy to better support and promote the wound-healing cascade is to prepare an autologous platelet concentrate suspended in plasma (platelet-rich plasma (PRP)) for application to wound sites in a wide variety of surgeries. The therapeutic effects of PRP are believed to result from the elevated levels of growth factors, for example, platelet-derived growth factor (PDGF) [4]. Using a porcine model, this study evaluated the feasibility of generating PRP with gravitational platelet separation and investigated the granulation process after application on the bronchial stump. 2. Material and
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