Use of autologous platelet-rich plasma in healing skin graft donor sites

Abstract

Objective: To demonstrate that the use of platelet-rich plasma (PRP) enhances both the quality of healing and the time required for wound healing at a skin graft donor site. Methods: Patients who had dermo-epidermal skin grafts taken from the thigh area were included in a prospective, randomised clinical study. PRP was applied to one donor site and then covered with Vaseline-impregnated, open-weave gauze and gauze, while the contralateral donor site on the other thigh served as a control and was covered with the open-weave gauze and gauze without PRP. Results: A total of 24 patients took part in the study, of which three developed infections and were thus removed from the study. Use of PRP reduced the wound healing time of the dermo-epidermal graft donor sites by a mean 17.8% and median 18 days. On average, the treated donor sites healed in 14.9 days compared with 18.4 days for the control group. The median was 14 days compared with 18 days in the control group (p=0.026). In one patient, healing was slower on the side where PRP was applied. In 20 patients, healing of the donor site was accelerated where PRP was applied. Conclusion: The study demonstrated a beneficial effect of PRP, as healing time was shortened. Using PRP to heal wounds could be beneficial for patients for whom commonly available wound healing therapies have failed, as well as for high-risk patient groups for whom problematic wound healing may be expected.

Platelet-Rich Plasma in Plastic Surgery: A Systematic Review

“…Two randomized controlled trials (RCTs) compared PRP application to conventional fixation with split-thickness skin grafts (STSGs) [15, 16]. In 1 case, PRP was applied to the donor site to accelerate wound healing [17]. Two studies aimed to reduce postoperative complications after breast reconstruction with PRP application [18, 19].…”

“…Many factors had to be considered, such as differences in number of PRP applications or the use of activators. In seventeen studies [10, 11, 13-15, 21, 24, 27, 31, 34, 35, 38, 40-42, 50, 53], double spin centrifugation was performed, 21 studies used a single spin protocol [16, 17, 19-23, 29, 30, 32, 33, 36, 37, 43-49, 51, 58], and twelve authors merely disclosed the name of the device used, or no information about this process at all [12, 18, 25, 26, 28, 39, 52, 54-57, 59]. Twenty-two authors reported the use of CaCl and/or Thrb for platelet activation [11, 13-15, 18, 19, 21, 24, 28, 30, 31, 37, 39, 42-47, 50, 51, 58].…”

The roles of serotonin in cell adhesion and migration, and cytoskeletal remodeling

“…Serotonin is seen to promote cell migration, proliferation, survival, and antiapoptotic effects in keratinocytes and fibroblasts [53]. Moreover, numerous lines of evidence also suggest that autologous platelets enhance healing of skin wounds in humans [54]. Platelets are significant reservoirs for serotonin, and the mechanism could be serotoninmediated adhesion and migration of cells involved in tissue repair.…”

Theory and Evidence for Platelet Therapy of the Aging Face

“…20 Two studies showed that the application of L-PRP and L-PRF to split thickness skin graft donor sites improved healing time and postoperative scarring significantly in patients in whom platelet preparation was applied to the donor site at the time of harvest. 21,22…”