Background: Autogenous fat grafting and platelet-rich plasma (PRP) have shown potential in enhancing nerve regeneration due to their biological properties, including growth factor release and anti-inflammatory effects. The present work aimed to compare the regenerative outcomes in peripheral nerves treated with fat graft versus PRP, focusing on key indicators of nerve growth and function in male albino rats.

Methods: In this experimental study, 18 male albino rats (250-350 g) were included, with 4 serving as PRP donors. In Group A (left side), 0.3 ml of abdominal fat was injected around the epineurial nerve graft repair site, while Group B (right side) received 0.3 ml of activated PRP. At 12 weeks, 15 mm sciatic nerve segments were harvested, fixed in formalin, and analyzed histopathologically to evaluate the number of regenerated nerve fibers, myelinated axons, axonal diameter, and neurotization index.

Results: Group A (Fat Graft) demonstrated significantly higher proximal myelinated axons (196.36 ± 68.36, p=0.026) and distal axons (173.71 ± 59.32, p=0.020) compared to Group B (PRP), which had 147.29 ± 54.91 proximal axons and 115.86 ± 43.10 distal axons. Proximal regenerated fibers were also higher in Group A (313.28 ± 87.34 vs. 252.57 ± 69.08).

Conclusion: Autogenous fat grafting enhanced nerve graft regeneration compared to PRP in male albino rats. The higher neurotization index indicates that autogenous fat grafting not only promotes nerve fiber regeneration but also enhances graft integration and functional recovery, which is crucial for restoring nerve function.