Autologous Platelet Rich Plasma As A Preparative for Resurfacing Burn Wounds with Split Thickness Skin Grafts
World J Plast Surg. 2020;9(1):29-32
BACKGROUND Split thickness skin graft is a widely accepted technique to cover large defects. Shearing, hematoma and infection have often been attributed as major causes for graft loss. Autologous platelet rich plasma (PRP) has been used in various treatment modalities in the field of plastic surgery for its healing, adhesive and hemostatic properties owing to the growth factors that are released. This Study primarily throws light on the usage of PRP over difficult Burn wound beds to augment graft uptake and attenuate complications. METHODS The patients were divided into two groups of those who were subjected to use of autologous PRP as a preparative burn surfacing and the control group who underwent standard method of treatment. RESULTS Patients in PRP group significantly showed a higher graft adherence rate as compared to those with other method. It also reduced pain, and hematoma formation. CONCLUSION Application of PRP is a safe, cost effective, easy method to increase graft adherence rate in patients with burns where graft loss is noticed and there is shortage of donor sites.
Evaluation of the Effect of Platelet-Rich Fibrin on Wound Healing at Split-Thickness Skin Graft Donor Sites: A Randomized, Placebo-Controlled, Triple-Blind Study
The international journal of lower extremity wounds. 2020;:1534734619900432
Split-thickness skin grafting (STSG) is widely used to heal wounds resulting from trauma, burns, and chronic wounds. This study aimed to determine the true effect of platelet-rich fibrin (PRF) on patients with burn wounds requiring STSG during treatment of donor wounds. This randomized, triple-blind clinical trial was conducted on patients who referred to the burn ward of Vasei Hospital of Sabzevar, Iran, from May 2017 to May 2018. The donor site was randomly divided into 2 groups: PRF and control (Vaseline petrolatum gauze) using Vaseline gauze. In the intervention group, the PRF gel was applied to the wound and covered with Vaseline gauze and wet dressing. Conversely, only Vaseline gauze and wet dressing were applied to the control group. Outcome evaluation was conducted using paired t test and Wilcoxon signed rank-sum test, as appropriate, on days 8 and 15. The mean age of the patients was 33.10 +/- 2.60 years, and 51.50% were male. The mean wound healing time in the PRF and control groups was 11.80 +/- 3.51 and 16.30 +/- 4.32 days, respectively (P < .001). The PRF group showed significantly higher wound healing rates than the control group at 8 and 15 days dressing (P < .001 and P < .001, respectively). Moreover, the mean wound healing for all wound healing indices diagnosed by 2 specialists in PRF was higher than control group on days 8 and 15 (P < .001). We found a statistically significant difference on days 8 and 15 regarding the mean pain levels between the 2 groups (P < .001). The findings showed that PRF can significantly increase the time and rate of donor wound healing compared with conventional treatment and also reduce the severity of pain.
Effectiveness of platelet rich plasma in burn wound healing: A systematic review and meta-analysis
The Journal of dermatological treatment. 2020;:1-25
Background: To evaluate the efficacy of platelet-rich plasma (PRP) in the treatment of burn wounds.Methods: A comprehensive literature survey was conducted in electronic medical journal databases to identify studies that examined the effect of PRP treatment to burn wounds and meta-analyses of mean differences (MD) standardized MD, or odds ratios (OR) were performed.Results: The percentage of graft take was not significantly different between PRP-treated and control wound areas. Healing rate was significantly better in PRP-treated wounds. Healing time was also significantly less in PRP-treated wounds. There was no significant difference between PRP-treated and control wound areas in epithelialization, or in the incidence of adverse events. Incidence of infection was also not different between PRP-treated and control wound areas. Scar assessment score was significantly better in PRP-treated than in control wound areas.Conclusion: PRP treatment to burn wounds is found to improve healing. Variations in study design and sample size, types of wounds, PRP preparation protocols, and high risk of bias in some of the included studies may have impact on these outcomes.
The effect of mesenchymal stem cells combined with platelet-rich plasma on skin wound healing
Journal of Cosmetic Dermatology. 2018;17((5):):650-659
INTRODUCTION Mesenchymal stem cells (MSCs) are multipotent stem cells that have the potential of proliferation, high self-renewal, and the potential of multilineage differentiation. The differentiation potential of the MSCs in vivo and in vitro has caused these cells to be regarded as potentially appropriate tools for wound healing. After the burn, trauma or removal of the tumor of wide wounds is developed. Although standard treatment for skin wounds is primary healing or skin grafting, they are not always practical mainly because of limited autologous skin grafting. EVIDENCE ACQUISITIONS Directory of Open Access Journals (DOAJ), Google Scholar, PubMed (NLM), LISTA (EBSCO), and Web of Science have been searched. EVIDENCE SYNTHESIS For clinical use of the MSCs in wound healing, two key issues should be taken into account: First, engineering biocompatible scaffolds clinical use of which leads to the least amount of side effects without any immunologic response and secondly, use of stem cells secretions with the least amount of clinical complications despite their high capability of healing damage. CONCLUSION In light of the MSCs' high capability of proliferation and multilineage differentiation as well as their significant role in modulating immunity, these cells can be used in combination with tissue engineering techniques. Moreover, the MSCs' secretions can be used in cell therapy to heal many types of wounds. The combination of MSCs and PRP aids wound healing which could potentially be used to promote wound healing.
Efficacy of lyophilised patlet-rich plasma powder on healing rate in patients with deep second degree burn injury: a prospective double-blind randomized clinical trial
Annals of Plastic Surgery. 2018;80((2S, Suppl 1):):S66-S69.
Platelet-rich plasma (PRP) is a kind of plasma that is rich in platelets after processing. It includes various growth factors and cytokines, which speed up the process of wound healing and hemostasis. The PRP solution used in this study is diluted from lyophilized PRP powder, which decreased the possibility of contamination, facilitated the storage, and prolonged the storage life. From in vitro fibroblast proliferation testing, the numbers of PRP supplement were performed for 1, 4, and 7 times by continuous replacement of culture medium each day. Four times of lyophilized PRP supplement was selected for clinical study due to sufficient promotion of fibroblast proliferation. Next, 27 patients of deep second-degree burn wound were included in this study. Patients were assigned to two groups: PRP group (n = 15) and control group (n = 12). A concentration of 1.0 x 10 platelets/cm (wound area) according to wound size was sprayed on the wound evenly. Function was mainly assessed by the percentage of wound closure and bacteria picking out rate in 2 and 3 weeks. The wound closure at 3 weeks showed a significant difference in PRP group (P < 0.05). The healing rate of PRP group reached nearly 80% and made a breakthrough of 90% in 3 weeks, showing a significant difference compared with the control group (P < 0.05). Lyophilized PRP can be considered as an effective treatment to increase healing rate in patients with deep second-degree burn injury.
The application of platelet rich plasma in the treatment of deep dermal burns: a randomized, double blind, intra-patient controlled study
Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society. 2016;24((4):):712-20
Platelet rich plasma (PRP) is a fraction of blood with a platelet concentration above baseline. When platelets get activated, growth factors involved in wound healing are released. The application of PRP has shown good results in wound care, however up to date no substantial research has been performed on the effect of PRP in burn treatment. This randomized double blind intra-patient controlled study investigates the effect of autologous PRP on wound healing in burns that require surgery with a meshed split skin graft (SSG). 52 patients with various areas of deep dermal to full thickness burns, receiving surgery with a SSG were included after informed consent. Comparable study areas A and B (intra patient) were appointed, randomized and either treated with a SSG and PRP or with a SSG alone. At day 5 to 7 post- operative, the epithelialization and graft take rate were assessed. 3, 6 and 12 months post-operative, follow-up measurements were performed in the form of POSAS-questionnaires, DermoSpectroMeter and Cutometer measurements. There was no statistically significant difference between the mean take rate nor the mean epithelialization rate at day 5-7 between the PRP-treated and control areas. However, PRP-treated wound areas showed more often better or equal epithelialization and take rates at day 5-7 than the standard treated areas. Minor effects were also seen in the re-operated and early operated subgroups. At 3, 6 and 12 months post operative, POSAS scores from the patients and the observers, Dermaspectro- and Cutometer measurements did not depict a significant difference between the PRP and standard treated areas. Concluding, the addition of PRP in the treatment of burn wounds did not result in improved graft take and epithelialization, nor could we demonstrate better scar quality. There was, however, a considerable variation in our clinical population. This article is protected by copyright. All rights reserved.
Autologous keratinocyte suspension in platelet concentrate accelerates and enhances wound healing - a prospective randomized clinical trial on skin graft donor sites: platelet concentrate and keratinocytes on donor sites
Fibrogenesis & Tissue Repair. 2013;6((1):):8
BACKGROUND Wound healing involves complex mechanisms, which, if properly chaperoned, can enhance patient recovery. The abilities of platelets and keratinocytes may be harnessed in order to stimulate wound healing through the formation of platelet clots, the release of several growth factors and cytokines, and cell proliferation. The aim of the study was to test whether autologous keratinocyte suspensions in platelet concentrate would improve wound healing. The study was conducted at the Lausanne University Hospital, Switzerland in 45 patients, randomized to three different topical treatment groups: standard treatment serving as control, autologous platelet concentrate (PC) and keratinocytes suspended in autologous platelet concentrate (PC+K). Split thickness skin graft donor sites were chosen on the anterolateral thighs of patients undergoing plastic surgery for a variety of defects. Wound healing was assessed by the duration and quality of the healing process. Pain intensity was evaluated at day five. RESULTS Healing time was reduced from 13.9+/-0.5 days (mean+/-SEM) in the control group to 7.2+/-0.2 days in the PC group (P<0.01). An addition of keratinocytes in suspension further reduced the healing time to 5.7+/-0.2 days. Pain was reduced in both the PC and PC+K groups. Data showed a statistically detectable advantage of using PC+K over PC alone (P<0.01). CONCLUSION The results demonstrate the positive contribution of autologous platelets combined with keratinocytes in stimulating wound healing and reducing pain. This strikingly simple approach could have a significant impact on patient care, especially critically burned victims for whom time is of the essence. CLINICAL TRIAL REGISTRY INFORMATION Protocol Record Identification Number: 132/03. Registry URL: http://www.clinicaltrials.gov.