Considerations on the Use of Platelet-Rich Plasma, Specifically for Burn Treatment

Abstract

Platelet-rich plasma (PRP) is a fraction of blood plasma with a platelet concentration above baseline. After activation of the platelets, growth factors are released, which are involved in wound-healing processes. Application of a multitude of growth factors seems to boost the healing process. In this review the authors provide a comprehensive overview of the many different aspects of PRP; this is followed by a short outline of the evidence for a wide range of applications and finally narrowing down to a more in-depth analysis of the literature on the potential use of PRP in burn treatment. The authors performed an extensive search on PRP and the different biological, as well as practical aspects for the different applications. Furthermore, we performed a systematic search on PRP in the treatment of burn wounds. A high variety exists in PRP products, procedures, and content. This makes interpretation and comparison of the evidence difficult. PRP has been reported to have beneficial effects on wound healing in different fields of surgery and in the treatment of acute, chronic, and diabetic wounds. Literature on the use of PRP in burns is scarce. Separate growth factors have shown beneficial results in the treatment of burns. Furthermore, an animal study and several case reports showed improved burn wound-healing time after the application of PRP. A deep dermal burn could benefit from PRP through its hemostatic antimicrobial abilities and the positive effects seen in wound healing. However, burn patients have an altered physiological state and it is unknown how this may affect platelet function and quality. Furthermore, the effect of PRP on scarring has not been evaluated properly. Future research is needed to elucidate the role of PRP in the treatment of burns.

The effect of intradermal administration of inactive platelet-rich plasma on flap viability in rats

“…There are granules in platelets called alfa, beta and lambda granules and alfa granules contains many growth factors including epidermal growth factor (EGF), fibroblast growth factor (FGF), insulin-like growth factor (IGF), keratinocyte growth factor (KGF), plateletderived growth factor (PDGF), transforming growth factor-beta (TGF-b) and vascular endothelial growth factor (VEGF) 5 . PRP, with its high-level growth factor contents, is used clinically for bone and wound healing, oralmaxillofacial surgery, dental surgery and plastic surgery 6,7 .…”

Platelet-Rich Plasma in Burn Treatment

“…On the other hand, how PRP, a cocktail of many different growth factors, might influence scar formation remains to be seen. There are a limited number of publications on the development of hypertrophic scarring after the use of PRP in wound healing until now, and most of these publications are not related to burn trauma [76]. One of these studies is authored by Prochazka et al They reported that while in burn patients treated with PRP combination, the rate of reepithelialization may not have been higher or faster than traditionally observed, the inflammatory markers normalized faster, providing the reepithelialized wound more stable.…”

“…One of these studies is authored by Prochazka et al They reported that while in burn patients treated with PRP combination, the rate of reepithelialization may not have been higher or faster than traditionally observed, the inflammatory markers normalized faster, providing the reepithelialized wound more stable. Because patients treated with PRP combination showed minimal cicatrization, they had high quality of healing without evidence of scar hypertrophy or contractures [76]. Additionally, recently some reports were published with positive results of PRP in combination with adipose cells for scar treatment; therefore, there might be an indication for PRP in the reconstructive aspect of burn treatment.…”

“…There is little data about how burns or other traumas affect platelet and platelet function. In patients who have been exposed to trauma, it has been demonstrated that platelets were activated at least 72 h after injury and had an increased functionality in the first 48 h. This might affect the quality of PRP and the timing of its application in burn patients [76]. Table 6.…”

“…Furthermore, the positive effects of PRP on wound healing, as seen in reports on PRP in in vitro models, chronic and acute wounds, could contribute to faster closure of mesh interstices, because PRP promotes vascular ingrowth and fibroblast proliferation and possibly reepithelialization. A deep dermal burn also could benefit from PRP through its hemostatic antimicrobial abilities [73][74][75][76].…”