The Effectiveness of Autologous Platelet-Rich Plasma vs Conventional Mechanical Suture Fixation in Skin Graft Transfer for Deep Burn Patients: An Intra-Patient Controlled Study

Abstract

Background: Autologous platelet-rich plasma (PRP) is a patient-derived treatment containing fibrin and high concentrations of growth factors, often known for its adhesive and hemostatic abilities. PRP has been used for various types of wounds, including chronic and burn wounds. Autologous PRP is an affordable and practical modality that has been advocated by multiple publications due to its effect in improving clinical outcomes and wound healing time in regard to skin graft in burn patients. The aim of this study is to compare the effectiveness of PRP to conventional suture fixation in skin graft transfer for deep burn patients through objective "take" percentage analysis. Methods: This controlled prospective single center study included 15 deep burn patients with a total burn area of 5-30% on their extremities. Each patient received skin graft treatments using both methods: autologous PRP and conventional sutures. Pictures and analysis were taken on the third day after surgery to compare the open wound area between the two methods. Result: There was no significant "take" percentage difference between the autologous PRP and conventional suture group. The mean percentage of skin graft "take" for autologous PRP was 84.36% ± 13.82%, and the result for suture fixation was 84.16% ± 15.33%. Conclusion: The use of autologous PRP in this study did not improve the "take" percentage of skin grafts compared to conventional suture fixation. However, the use of autologous PRP did reduce the surgery duration and is still a treatment modality with high potential.

The application of platelet‐rich plasma for skin graft enrichment: A meta‐analysis

“…After reviewing the full text, another 12 articles were excluded for the following reasons: without any outcome measures of interest (n = 1); lack of controlled study (n = 3); retrospective study (n = 2); PRP used in donor sites (n = 4); study with fewer than 10 participants (n = 1); and no original data (n = 1). Finally, the remaining 11 studies [13][14][15][16][17][18][19][20][21][22][23] were eligible. See Figure 1 for the flowchart of studies search and selection.…”

“…The preparation protocols of PRP differed among the included studies. Rate of skin graft take was reported in five studies 14,18‐20,22 . Five studies 16,17,21‐23 recorded the number of skin graft loss.…”

“…Of these cases, 466 cases belonged to PRP group and 444 cases belonged to control group. The type of skin graft in 10 studies was STSG [13][14][15][16][17][19][20][21][22][23] but one study 18 did not clarify the type of skin graft. The preparation protocols of PRP differed among the included studies.…”

“…Rate of skin graft take was reported in five studies. 14,[18][19][20]22 Five studies 16,17,[21][22][23] recorded the number of skin graft loss. Three studies 16,17,23 documented the number of haematoma formation, skin graft oedema and weeping occurrence on recipient sites.…”

“…A total of 294 cases were included in five studies 14,[18][19][20]22 in the comparison of the rate of skin graft take between two groups. Compared with the control group, the PRP group had a significantly higher rate of skin graft take (MD = 5.47%; 95% CI, 2.80-8.14%; P < .0001), and the heterogeneity was low (I 2 = 19%; P = .30).…”