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Platelet-Rich Plasma and Adipose Stem Cells Improve Burn Wound Healing in Yorkshire Pigs
Isaac James, MD, Debra Bourne, MD, Sheri Wang, BS, Mayara Silva, MD, Kassandra Albright, BS, Damian Grybowski, MD, M. Asher Schusterman II, MD, Liyong Zhang, PhD, Latha Satish, PhD, Kacey G. Marra, PhD, J. Peter Rubin, MD
UPMC
2017-01-25
Presenter: Isaac James
Affidavit:
This is original work.
Director Name: VTN
Author Category: Resident Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
BACKGROUND: Full-thickness burns often result in hypertrophic scarring and contracture across joints. Adipose stem cells (ASCs) and platelet-rich plasma (PRP) enhance neovascularization and epithelialization in excisional wounds, but data for burn wounds is limited.
METHODS: 40 burn wounds were created on the backs of two female Yorkshire pigs using an electric branding iron. Wounds were debrided 48 hours after injury and covered with STSG from the flanks. Saline, autologous PRP (1.2*10^9 platelets/ml), low-passage allogeneic ASCs (48*10^6 cells/wound), or PRP + ASCs were injected into the superficial wound bed (n=8 wounds/group). Wounds were assessed by surface area tracing done at dressing changes and animals were sacrificed at 2 weeks and 4 weeks post-operative. Wound biopsies were collected at sacrifice for histology and protein quantification via Western blot.
RESULTS: At 3 weeks, wound contraction trended lower in ASC (14.8+/-9.8%; p=0.19) and PRP+ASC groups (19.1+/-4.1%; p=0.23) compared to saline controls (27.7+/-9.9%). When compared to saline control at 4 weeks, CD31 was significantly higher in groups receiving ASCs (10.1-fold increase, p<0.01) and trended higher in PRP and PRP+ASC groups (7.5-fold, p=0.08 and 11.6-fold, p=0.10 respectively). CD31 content in groups treated with PRP, ASCs, and PRP+ASCs was much closer to unwounded controls, although it still trended lower by 2.7 (p=0.14), 2.0 (p=0.18), and 1.8-fold (p=0.26) respectively.
CONCLUSION: ASCs and PRP appear to reduce early wound contraction after skin grafting and elevate markers of neovascularization in burn wounds. Longer studies are needed to fully evaluate wound healing.
