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Platelet-Rich Plasma Reduces Wound Contracture After Full Thickness Burn Injury Treated With Split-Thickness-Skin-Grafting In Yorkshire Pigs.
Grybowski D, James IB, Bourne D, Wang S, Silva M, Satish L, Marra K, Rubin JP.
University of Pittsburgh Dept. of Plastic Surgery
2016-02-01
Presenter: Damian Grybowski
Affidavit:
The presented material has not been previously published or presented at a major meeting. The work below represents the original work of the individual submitting.
Director Name: not a resident
Author Category: Medical Student
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
BACKGROUND: Burn injuries are the 4th most common type of trauma worldwide and often require recurrent surgical revision to treat the sequelae of wound contracture. Hypertrophic scarring and contracture across joints can result in severe functional and aesthetic impairment, and treating those complications accounts for as much as 1/3 of the operative burden in burn care. Platelet-rich plasma (PRP) appears to enhance closure in chronic non-healing wounds, but data for burn wounds remains limited. We sought to assess PRP as a treatment for wound contracture following burns treated with split-thickness-skin-grafting (STSG).
METHODS: Burn wounds were created on the backs of 60-70kg female Yorkshire pigs using an electric brand heated to 200C and applied for 40s. Wounds were debrided 48hrs after injury and treated with meshed STSG. 100% PRP (1.3*10^9 platelets/ml), 10% PRP diluted in saline (0.12*10^9 platelets/ml), or saline control (n=4 wounds/group) was injected into the superficial wound bed and around the wound periphery. Bolsters were applied for 7d, followed by assessment of graft take and standard wound care. Wounds were assessed during dressing changes and animals were sacrificed 2wks post-operative.
RESULTS: No differences were seen in graft adherence or granulation. No groups experienced clinically significant wound infections. At 2wks post-grafting, 100% PRP reduced wound contracture by two-fold versus saline control (11.9+/-2.7% vs 23.9+/-5.4% respectively; p<0.05). 10% PRP was not significantly different from control.
CONCLUSION: PRP represents an exciting potential therapy for limiting burn wound contracture. Platelet dose appears to influence efficacy and will be further optimized in future studies.
