The use of autologous platelet-rich plasma gel increases wound healing and reduces scar development in split-thickness skin graft donor sites

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.

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CICAFAST: comparison of a biological dressing composed of fetal fibroblasts and keratinocytes on a split-thickness skin graft donor site versus a traditional dressing: a randomized controlled trial

Trials ◽

10.1186/s13063-019-3718-4 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Alexandra Poinas ◽

Pierre Perrot ◽

Judith Lorant ◽

Olivier Nerrière ◽

Jean-Michel Nguyen ◽

...

Keyword(s):

Wound Healing ◽

Growth Factors ◽

Skin Graft ◽

Donor Site ◽

Split Thickness Skin Graft ◽

Skin Grafts ◽

Thickness Skin ◽

Fetal Fibroblasts ◽

Biological Dressing ◽

Graft Donor

Abstract Background Wound repair is one of the most complex biological processes of human life. Allogeneic cell-based engineered skin substitutes provide off-the-shelf temporary wound coverage and act as biologically active dressings, releasing growth factors, cytokines and extracellular matrix components essential for proper wound healing. However, they are susceptible to immune rejection and this is their major weakness. Thanks to their low immunogenicity and high effectiveness in regeneration, fetal skin cells represent an attractive alternative to the commonly used autologous and allogeneic skin grafts. Methods/design We developed a new dressing comprising a collagen matrix seeded with a specific ratio of active fetal fibroblasts and keratinocytes. These produce a variety of healing growth factors and cytokines which will increase the speed of wound healing and induce an immunotolerant state, with a slight inflammatory reaction and a reduction in pain. The objective of this study is to demonstrate that the use of this biological dressing for wound healing at the split-thickness skin graft (STSG) donor site, reduces the time to healing, decreases other co-morbidities, such as pain, and improves the appearance of the scar. This investigation will be conducted as part of a randomized study comparing our new biological dressing with a conventional treatment in a single patient, thus avoiding the factors that may influence the healing of a graft donor site. Discussion This clinical trial should enable the development of a new strategy for STSG donor-wound healing based on a regenerative dressing. The pain experienced in the first few days of STSG healing is well known due to the exposure of sensory nerve endings. Reducing this pain will also reduce analgesic drug intake and the duration of sick leave. Our biological dressing will meet the essential need of surgeons to “re-crop” from existing donor sites, e.g., for thermal-burn patients. By accelerating healing, improving the appearance of the scar and reducing pain, we hope to improve the conditions of treatment for skin grafts. Trial registration ClinicalTrials.gov, ID: NCT03334656. Registered on 7 November 2017.

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Lipid-Colloid Dressing Shows Improved Reepithelialization, Pain Relief, and Corneal Barrier Function in Split-Thickness Skin-Graft Donor Wound Healing

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734614541544 ◽

2014 ◽

Vol 13 (3) ◽

pp. 220-225 ◽

Cited By ~ 8

Author(s):

Katsuya Tanaka ◽

Sadanori Akita ◽

Hiroshi Yoshimoto ◽

Seiji Houbara ◽

Akiyoshi Hirano

Keyword(s):

Wound Healing ◽

Pain Relief ◽

Skin Graft ◽

Barrier Function ◽

Split Thickness Skin Graft ◽

Thickness Skin ◽

Graft Donor

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Application of Honey and Transparent Dressing to Split Thickness Skin Graft Donor Site and Its Effect on Epithelialization Rate

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v1i3.73 ◽

1970 ◽

Vol 1 (3) ◽

Author(s):

Teuku A. ◽

Nandita Melati P. ◽

Gentur Sudjatmiko ◽

Asrofi S. ◽

Ishandono D.

Keyword(s):

Clinical Trial ◽

Wound Healing ◽

Skin Graft ◽

Donor Site ◽

Split Thickness Skin Graft ◽

Parallel Design ◽

Thickness Skin ◽

Graft Donor ◽

The Mean ◽

Clinical Photograph

Background: Split thickness skin graft (STSG) is one of the modalities used to close a defect. The donor site can be healed secondarily with tulle grass and moist gauze after 14 days and with transparent dressing will take about 10-13 days. Recently the wound healing by using honey application has been used. Whether or not using honey application with transparent dressing will hasten the epithelialization rate of the STSG donor site is now in question. Method: This research is an open, non-randomized clinical trial with a parallel design and intervention using honey application with transparent dressing. A total of 19 patients (7 female and 8 male) were included in this study. The reapplication of honey was done every two days. The patients was followed up every day, with clinical photograph taken and complaints such as pain, odor and infection noted. Results: The mean epithelialization rate of the donor site treated with honey and transparent dressing was 9,74 (+0,24) days compared to 10,79 (+1,23) days in the transparent-dressing-only group (p=0,00). Conclusion: The application of honey with transparent dressing to cover for STSG donor site led to a faster epithelialization rate, less odor and less pain. Commercial honey was used, and readily available.

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