164 | Analysis of the regenerative capacity and biochemical composition of pediatric platelet rich plasma in oronasal fistulas

Anna Barbara Di Stefano¹, Daniele Matta², Francesca Toia^1|2 | ¹Department of Precision Medicine in Medical, Surgical and Critical Care, Plastic and Reconstructive Surgery Section, Palermo, Italy; ²BIOPLAST-Laboratory of BIOlogy and Regenerative Medicine-PLASTic Surgery, University of Palermo, Italy; ²Department of Precision Medicine in Medical, Surgical and Critical Care, Plastic and Reconstructive Surgery Section, University of Palermo, Italy.

Platelet rich plasma is widely used in the surgical field. Although, no study has ever analyzed the concentration of the analytes in platelet rich plasma samples and its possible use in the treatment of pediatric oronasal fistulas. This work aimed to investigate the safety and efficacy of pediatric platelet rich plasma in the management of patients with non-syndromic oronasal fistulas using standard surgical procedures. Five patients with a diagnosis of nonsyndromic cleft palate were included in a non-randomized experimental study with a diagnosis of secondary oronasal fistulas and underwent platelet plasma infiltra-tion in the perifistulous lip and adjacent areas of the palate. A luminex assay was performed on the samples. A biopsy of the mucosa adjacent to the fistula was performed during corrective surgery and analyzed. For the first time, we analyzed the molecular composition (growth factors, chemokines and cytokines) of the platelet rich plasma -pediatric, that could be involved in regenerative and wound repair processes, demonstrating a different composition from adult one, although not significant. 17 factors were up-regulated in platelet rich plasma-pediatric, such as IL-1b, SDF-1a and IL-6, compared to platelet rich plasma-adult. We also observed a dimensional reduction of the defect after the infiltration of platelet rich plasma varying between 50% and 20% (mean value 34,8%). Biopsies show acute/chronic inflammation with lymphogranulocytic infiltrate, neovascularization, fibrous hyperplasia and epithelial changes indicative of mucosal reparative processes. Our preliminary results showed a substantial difference between samples, demonstrating improved properties of pediatric platelet plasma.