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

Lisa Hasibuan^1, and Miradz Hudaya²

¹Plastic and Reconstructive Surgery Division, Department of Surgery, Rumah Sakit Hasan Sadikin, Bandung, Indonesia

²Department of Surgery, Plastic and Reconstructive Surgery, Rumah Sakit Hasan Sadikin, Bandung, Indonesia

Cite this paper

Lisa Hasibuan and Miradz Hudaya. 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. American Journal of Clinical Medicine Research. 2019; 7(2):53-56. doi: 10.12691/AJCMR-7-2-4

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.

Keywords

burns, skin transplantation, platelet-rich plasma, sutures, graft survival

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	B-NBRP T. Bi-National Burns Registry: Annual Report. Aust New Zeal Burn Assoc. 2013.
[2]	Burn Incidence and Treatment in the United States: 2013 Fact Sheet. Am Burn Assoc. 2013.
[3]	Burns: Fact Sheet 2017 [Internet]. World Health Organization. 2017 [cited 2019 Feb 15]. Available from: http://www.who.int/mediacentre/factsheets/fs365/en/.
[4]	Pallua N, Wolter T, Markowicz M. Platelet-Rich Plasma in Burns. Burns. 2010; 36(1): 4-8.
[5]	Monstrey S, Hoeksema H, Verbelen J, Pirayesh A, Blondeel P. Assessment of burn depth and burn wound healing potential. Burns. 2010; 34(6): 761-9.
[6]	Wasiak J, Cleland H, Campbell F. Dressings for Superficial and Partial Thickness Burns. Cochrane Database Syst Rev. 2013; 3.
[7]	Waiker VP, Shivalingappa S. Comparison between Conventional Mechanical Fixation and Use of Autologous Platelet Rich Plasma ( PRP ) in Wound Beds Prior to Resurfacing with Split Thickness Skin Graft. 2015; 4(1): 50-9.
[8]	Marck RE, Gardien KLM, Stekelenburg CM, Vehmeijer M, Baas D, Tuinebreijer WE. The application of platelet-rich plasma in the treatment of deep dermal burns: A randomized , double-blind , intra- patient controlled study. Wound Rep Reg. 2016; 00: 1-9.
[9]	Thorne C, Aston S, Barlett S, Gurtner G, Spear S. Techniques and Principles in Plastic Surgery. In: Thorne C, editor. Grabb and Smith’s Plastic Surgery. 7th ed. Philadelphia; 2014. p. 1-12.
[10]	Eppley BL, Pietrzak WS, Blanton M. Platelet-Rich Plasma: A Review of Biology and Applications in Plastic Surgery. Plast Reconstr Surg. 2006; 147-59.
[11]	Reddy S, Fancourt M, Farrant G, Gilkison W, Henderson N, Kyle S, et al. The Incidence and Risk Factors for Lower Limb Skin Graft Failure. Dermatol Res Pract. 2014; 3.
[12]	Thimmanahalli GU, Kumar M. Efficacy of autologous platelet rich plasma over conventional mechanical fixation methods in split thickness skin grafting. 2019; 6(1): 108-13.
[13]	Foster T, Puskas B, Mandelbaum B, Gerhardt M, Rodeo S. Platelet rich plasma from basic science to clinical applications. Am J Sports Med. 2009; 37(11): 2259-72.
[14]	Boswell S, Cole B, Sundman E, Karas V, Fortier L. Platelet-Rich Plasma: A milieu of bioactive factors. Arthrosc J Arthrosc Relat Surg. 2012; 28(3): 429-39.
[15]	Dhurat R, Sukesh M. Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author’s Perspective. J Cutan Aesthet Surg. 2014; 7(4): 189-97.
[16]	Anitua E, Andia I, Ardaza B, Nurden P, Nurden A. Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost. 2004; 91(1): 4-15.
[17]	Gibran N, Luterman A, Herndon D, Lozano D, Greenhalgh D, Grubbs L. Comparison of fibrin sealant and staples for attaching split-thickness autologous sheet grafts in patients with deep partial or full thickness burn wounds: a phase 1/2 clinical study. J Burn Care Res. 2007; 28(3): 401-8.