Efficacy of autologous platelet rich plasma over conventional mechanical fixation methods in split thickness skin grafting

Abstract

Background: Platelet-Rich Plasma (PRP) is an autologous product derived from whole blood through the process of gradient density centrifugation. After skin graft reconstruction, the healing process is longer and may be difficult, depending on the wound site, skin defect size, and patient comorbidities. The potential value of PRP lies in its ability to incorporate high concentrations of platelet-derived growth factors into the skin graft. Since not all patients afford commercially available recombinant platelet rich plasma for skin graft, platelet extract from patient’s own blood is being used in this study to test and demonstrate the therapeutic role of PRP in skin graft. The aim of this randomized, prospective study is to compare the effectiveness of PRP in skin graft with conventional method like sutures, staplers or glue.Methods: The source of data were the patients admitted as inpatients for the management of wounds to the department of general surgery, JSS Hospital, Mysore from September 2016 to September 2018. Total of 60 patients were studied; 30 cases were randomly chosen for study with autologous platelet rich plasma and 30 cases received conventional methods like staples/sutures used to anchor the skin grafts in a control group.Results: Autologous PRP showed faster and better healing rates. With PRP study group instant graft adherence was seen in all cases. Hematoma, graft edema, discharge from graft site, frequency of dressings and duration of stay in hospital were significantly less in the PRP. There were no adverse effects or reactions seen with the use of autologous PRP among the study group.Conclusions: The combination of PRP with Split Thickness Skin Graft (STSG) significantly improved clinical outcomes and shortened the wound healing time. Therefore, this treatment combination could provide a way to heal skin after skin graft reconstruction with minimal recovery time. It is found to be highly beneficial in many aspects both to the patient and surgeon based on our results.

Autologous platelet-rich plasma enriched pixel grafting

“…PRP functions as a tissue sealant and drug delivery system, with the platelets initiating wound repair by releasing locally acting growth factors via α-granules degranulation. [ 5 ] The application of APRP to STSG application sites has been recently described and theorized to provide immediate skin graft anchorage as well as inosculation of the STSG with nutrient-rich blood media. [ 6 ] Studies conducted by Gibran et al .,[ 7 ] on burns patients, have proven that PRP is safe and effective for fixation of skin grafts due to its adhesive nature, and its outcomes are better than securing skin graft to wound margins or bed with sutures, staples, or glue, hence it not only decreases the surgery time but also avoids the removal of sutures/staplers in postoperative period.…”

Role of Autologous Platelet Rich Plasms (Aprp) In the Take of Full Thickness Skin Graft in Post Burn Contracture

“…PRP functions as a tissue sealant and drug delivery system, with the platelets initiating wound repair by releasing locally acting growth factors via α-granules degranulation. [4] The application of APRP to STSG application sites has been recently described and theorized to provide immediate skin graft anchorage as well as inosculation of the STSG with nutrient-rich blood media [5]. Some study on burns patients, have proven that PRP is safe and effective for fixation of skin grafts due to its adhesive nature, and its outcomes are better than securing skin graft to wound margins or bed with sutures, staples, or glue, hence it not only decreases the surgery time but also avoids the removal of sutures/staplers in postoperative period [6].…”

Comparison of Fixation and Uptake of Split Skin Graft Using Autologous Platelet Rich Plasma with Conventional Method for Ulcer

“…An autologous product called platelet-rich plasma (PRP) concentrates a lot of platelets into a small amount of plasma. PRP promotes soft tissue healing, lessens dermal scarring, speeds up endothelium, epithelial, and epidermal regeneration stimulates angiogenesis, boosts collagen synthesis, and improves the hemostatic response to injury [3].…”