Platelet rich plasma and plasma rich in growth factors for split-thickness skin graft donor site treatment in the burn patient setting: A randomized clinical trial |
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| Affiliation: | 1. Department of Plastic and Reconstructive Surgery and Burns, La Fe Hospital, Valencia, Spain;2. Center for Blood Transfusion and Tissue Bank of Valencian Community, Valencia, Spain;3. Regenerative Medicine and Heart Transplantation Unit, Health Research Institute Hospital La Fe, Valencia, Spain;1. Department of Plastic, Reconstructive & Aesthetic Surgery, Burn Unit, Klinikum Nuremberg Hospital, Paracelsus Medical University (PMU), Breslauer Str. 201, 90471 Nuremberg, Germany;2. ZEW – Leibniz Centre for European Economic Research, L7 1, 68161 Mannheim, Germany;3. German Society for Burn Treatment (DGV), Committee of the German Burn Registry, Luisenstrasse 58–59, 11, 10117 Berlin, Germany;1. Department of Orthopedics, Orthopedic Research Center, Poorsina Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran;2. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran;3. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran;1. Department of Burns and Plastic Surgery, Institution Shared with University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic;2. CEITEC – Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic;3. Clinical Immunology and Immunology of Infectious Diseases, Veterinary Research Institute, Brno, Czech Republic;4. Department of Microbiology, St. Anne''s University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic;1. Department of Burns and Plastic Surgery, City Hospital Campus, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, United Kingdom;2. The University of Nottingham Medical School, Nottingham NG7 2UH, United Kingdom;3. Postgraduate Medical Education Centre, City Hospital Campus, Nottingham University, Hospitals NHS Trust, Nottingham NG5 1PB, United Kingdom;1. Loyola Stritch School of Medicine, United States;2. Department of Surgery, Loyola University Medical Center, United States;3. Department of Public Health Sciences, Loyola University Chicago, United States;4. Department of Ophthalmology, Loyola University Medical Center, United States |
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| Abstract: | IntroductionManagement of donor site morbidity in the setting of split thickness skin graft (STSG) is of crucial importance with no superior wound dressing described to date and the growing need of decreasing epithelializing time. The purpose of the study was to compare the standard of care using a hydrocolloid dressing to platelet rich plasma (PRP) and plasma rich in growth factors (PRGF) in order to determine its therapeutic potential in this setting.MethodsA randomized clinical trial was conducted in which each patient served as its own control. PRGF was obtained by means of freeze-thaw out of the PRP from the subject of the study. Patients from the study had three donor sites and each donor site received either to PRP, PRGF or the standard of care, hydrocolloid. The main variable was time to epithelialization, and secondary variables subject to study were pain, quality of the scar, complications and cost.Results20 patients were recruited with a total number of 60 donor sites to study. On the 8th post-operative day 55% and 45% of the sites treated with PRP and PRGF, respectively, complete epithelialization was observed as compared to 20% of the sites treated with hydrocolloid, statistical significance was achieved between the latter two (p = 0.036). The areas treated with PRP and PRGF received inferior values on the visual analog scale on post-op day 5 and 8 compared to hydrocolloid. Values on wound healing metrics were lower in the PRP when compared to hydrocolloid. No adverse effects were recorded.ConclusionDonor site of STSG treated with PRP in the setting of the burn patient decreased time to epithelialization. In our study a better pain control and in scar quality was observed in both, the PRP and PRGF group. |
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| Keywords: | Platelet rich plasma Burn patient Skin graft donor site Therapy Pain management Epithelialization |
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