Improving bronchial stump necrosis outcomes with the use of platelet-poor plasma?

Abstract

DOI of original article: 10.1016/j.jss.2012.1 * Corresponding author. Indianapolis, IN 462 E-mail address: meddoc22@yahoo.com. 0022-4804/$ e see front matter a 2014 Elsev http://dx.doi.org/10.1016/j.jss.2013.02.046 Despite many advances and modifications in surgical technique, the development of postoperative bronchopleural fistula (BPF) following pulmonary resection remains a dreaded complication. Morbidity and mortality following BPF development can be exceptionally high [1,2]. Consequently, renewed efforts are being directed toward preemptive strategies to minimize the risk of BPF formation. Although several proposed risk factors have been identified, necrosis and/or the presence of vascular ischemia following surgery seems to play a prominent role in the development of BPFs [3,4]. Consequently, attention has focused on the intracellular milieu and role of cytokines, growth factors, and local hemostatic mechanisms in tissue necrosis and wound healing. The use of platelet-rich plasma (PRP) has been utilizedwith growing success in a number of clinical applications [5e7]. From these studies, PRP appears to play a crucial role in modulating local wound inflammation, hemostasis, and tissue remodeling. Paradoxically, in contrast to these studies, in a paper recently published in the Journal of Surgical Research, Santana-Rodriguez et al. reported a significant decrease in bronchial stump necrosis using local application of plateletpoor plasma (PPP) following pneumonectomy [8]. Whereas