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Perussolo J, Calciolari E, Dereka X, Donos N. Platelet-rich plasma and plasma rich in growth factors in extra-oral wound care. Periodontol 2000 2024. [PMID: 39056422 DOI: 10.1111/prd.12572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/23/2024] [Accepted: 04/15/2024] [Indexed: 07/28/2024]
Abstract
This narrative review evaluates the existing literature on the clinical efficacy and safety of platelet-rich plasma (PRP) and plasma rich in growth factors (PRGFs) in extra-oral wound care, considering their potential benefits and drawbacks. The review specifically focuses on the impact of these treatments on patients' quality of life, pain management, treatment costs, recurrence rates, and potential complications. Given the extensive literature and diverse range of extra-oral wound types in which these autologous platelet concentrates have been applied, this narrative review focuses on the most frequently described wound types, including diabetic foot ulcers, venous leg ulcers, pressure ulcers, surgical wounds, and burns. The use of PRP has been reported in various medical specialties, with a low risk of adverse events. While there is a growing interest in the use of PRGF with promising results, the available literature on this topic is still limited. Only a few studies evaluated patients' perception of the treatment and the relationship between treatment costs and clinical outcomes. Data on recurrence rates and complications also vary across studies. In conclusion, PRP and PRGF show promise as alternatives or as adjunctive therapies to conventional treatments for various extra-oral wounds and ulcers, leading to reduced wound size and accelerated healing time but should be considered on a case-by-case basis, taking into account the type and severity of the wound.
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Affiliation(s)
- Jeniffer Perussolo
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Medicine and Surgery, Dental School, University of Parma, Parma, Italy
| | - Xanthippi Dereka
- Department of Periodontology, School of Dentistry, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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2
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Chigurupati VS, Khanna S, Kumar S, Khanna R. Efficacy of platelet-rich plasma in alleviating split skin graft morbidities. J Cutan Aesthet Surg 2024; 17:50-54. [PMID: 38736856 PMCID: PMC11086927 DOI: 10.4103/jcas.jcas_14_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Introduction Skin grafting is a routinely employed technique to cover the skin defect. Though the skin grafts are technically effortless, they are tiresome because of the prolonged duration of hospital stay, labor-intensive, demanding repeated dressings, and also create a second wound. Platelet-rich plasma (PRP) is one that has a higher concentration of platelets than the blood. Alpha granules of the platelets are rich in growth factors. Aims and Objectives To assess the effect of PRP on split-thickness skin graft uptake and donor site healing. Materials and Methods In a single-center-based prospective study done from August 2018 to June 2020, 60 patients with acute and chronic wounds were divided into two equal groups. Autologous PRP was applied on the recipient wound bed and donor site in PRP group, and conventional methods like staples/sutures were used to anchor the skin grafts and standard of care of the donor site in a control group. Results Instantaneous graft adhesion was observed in all patients of PRP group. The first graft inspection was delayed. Seroma, hematoma, total number of dressings, and duration of stay in hospital were significantly reduced in the PRP group. Donor site pain in the postoperative period was notably reduced in PRP group. PRP also remarkably hastened the donor site healing. Conclusion The application of PRP promotes graft take, minimizes complications, enhances donor site wound healing, mitigates donor site pain, and has immense economic benefits due to the reduced number of dressing changes and shorter hospital stay.
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Affiliation(s)
- Veda Samhitha Chigurupati
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Seema Khanna
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Sandip Kumar
- Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Rahul Khanna
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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3
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Gupta S, Jain RK. Application of autologous platelet-rich plasma to graft donor sites to reduce pain and promote healing. J Wound Care 2022; 31:86-90. [PMID: 35077214 DOI: 10.12968/jowc.2022.31.1.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Platelet-rich plasma (PRP) is widely used for wound healing in medical care because of the numerous growth factors it contains. Traditionally, donor sites are left to heal with a primary dressing so wounds are not left open. However, a delay in healing accompanied by pain at a donor site is often seen. This study primarily throws light on the use of autologous PRP over split-thickness skin graft (STSG) donor sites to promote healing and reduce pain. METHOD The patients enrolled in this study in 2018-2019 were divided into two groups: the intervention group received autologous PRP applied topically at the donor site; in the control group, the wound was dressed traditionally. Pain scales were measured in the immediate postoperative period at six hours, 10 hours and 16 hours. The dressing was opened on the postoperative day 14 and observed for healing by an independent observer. RESULTS A total of 100 patients were included in the study. Patients in the PRP group showed statistically significant faster healing at postoperative day 14 compared with the control group (p<0.05), who required dressings for 3-4 weeks postoperatively. Pain scale scores in the postoperative period were significantly less in the PRP group at six hours postoperatively compared with the control group (p<0.05). There was a reduced incidence of hypertrophic scar formation in the small number of patients in the PRP group who had developed hypertrophic scar previously. CONCLUSION Application of PRP is a safe, cost-effective and easy method to achieve faster healing in graft donor site areas that are troublesome to both patients and doctors. It also reduces postoperative pain at donor sites. The authors recommend PRP is used more often in the management of donor sites for STSGs.
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Affiliation(s)
- Samarth Gupta
- Department of Plastic, Reconstructive and Burns Surgery, SMS Hospital Jaipur, India
| | - Rakesh Kumar Jain
- Department of Plastic, Reconstructive and Burns Surgery, SMS Hospital Jaipur, India
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Jain RK, Choudhary GM, Gupta G, Patil AN, Prakash GD, Jain AK. Reducing split-thickness skin grafting donor site agony; faster healing and decreased pain-role of platelet-rich plasma. Asian J Transfus Sci 2021; 15:195-198. [PMID: 34908754 PMCID: PMC8628236 DOI: 10.4103/ajts.ajts_39_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 08/31/2017] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The split-thickness skin graft harvested donor site is associated with prolonged healing, discomfort, and pain. Platelet-rich plasma (PRP) contains platelet-derived growth factors and has been widely used in chronic wounds and skin graft donor sites. PRP application is known to accelerate wound epithelialization rates, and also reduce postoperative wound site pain. MATERIALS AND METHODS We assessed 20 patients admitted to our hospital service who underwent split-thickness skin grafting (STSGs) with proximal half of the donor site treated with PRP. The dressing was conducted on postoperative day 7, 14, and 21. The donor site healing was assessed with serial photographs and donor site pain measured by numerical rating scale. RESULTS Complete healing of wounds (epithelialization) was present in 12 (60%) patients dressed with PRP. Pain on opening dressing was an average of 3.5 in PRP dressed wounds and 6.35 in control wounds. Patients dressed without PRP, none of them had complete epithelialization. All patients had partial healing and were less than the donor site dressed with PRP. Based on these results, skin graft donor site with PRP showed accelerated healing and reduced pain and discomfort compared to control without PRP. CONCLUSION PRP is a beneficial adjunct for reducing donor site pain and increased healing of donor site following STSG harvest.
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Affiliation(s)
- Rakesh Kumar Jain
- Department of Plastic Surgery, SMS Hospital and Medical College, Jaipur, Rajasthan, India
| | - Ghisulal M Choudhary
- Department of Plastic Surgery, SMS Hospital and Medical College, Jaipur, Rajasthan, India
| | - Gajendra Gupta
- Department of Pathology, Santokba Durlabji Hospital, Jaipur, Rajasthan, India
| | - Aditya N Patil
- Department of Plastic Surgery, SMS Hospital and Medical College, Jaipur, Rajasthan, India
| | - Gautam D Prakash
- Department of Plastic Surgery, SMS Hospital and Medical College, Jaipur, Rajasthan, India
| | - Ayush K Jain
- Department of Plastic Surgery, SMS Hospital and Medical College, Jaipur, Rajasthan, India
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Healing of Chronic Wounds with Platelet-Derived Growth Factors from Single Donor Platelet-Rich Plasma following One Freeze-Thaw Cycle. A Cross-Sectional Study. J Clin Med 2021; 10:jcm10245762. [PMID: 34945062 PMCID: PMC8705371 DOI: 10.3390/jcm10245762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 12/29/2022] Open
Abstract
Chronic non-healing wounds (CNHWs) may be associated with trauma or idiopathic in nature and are difficult to treat. Our objective was to assess the use of platelet-derived growth factor (PDGF) from single-donor platelets (al-PRP), using one freeze-thaw cycle, for treating CNHWs. We conducted a cross-sectional study. A total of 23 CNHWs being treated with al-PRP. The al-PRP treatment can be considered successful in well over half (n = 13, 56.5%) of the wounds. We found that all the wounds treated for up to 7 weeks showed partial or complete healing, while those treated for between 8 and 12 weeks did not show healing, healing again being successful in cases in which treatment was extended to more than 13 weeks (85.7%). Using chi-square tests, this relationship was found to be highly significant (p < 0.001, chi2 = 19.51; p value = 0.00006). Notably, Cramer's V coefficient was very high (0.921), indicating that the effect size of PRP treatment duration on healing is very large (84.8%). We could suggest that the use of al-PRP in the healing of CNHWs is a promising approach. Further studies with larger sample sizes and long follow-ups are needed to obtain multivariate models to explain which factors favour the healing of ulcers treated with PRP.
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He M, Guo X, Li T, Jiang X, Chen Y, Yuan Y, Chen B, Yang G, Fan Y, Liang Z, Armstrong DG, Deng W. Comparison of Allogeneic Platelet-rich Plasma With Autologous Platelet-rich Plasma for the Treatment of Diabetic Lower Extremity Ulcers. Cell Transplant 2021; 29:963689720931428. [PMID: 32510240 PMCID: PMC7563928 DOI: 10.1177/0963689720931428] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Autologous platelet-rich plasma (au-PRP) has been widely used for the management of refractory chronic wounds. However, patients with diabetic lower extremity ulcers (DLEUs) usually have complicated clinical conditions, and the utility of au-PRP is limited. In this study, the feasibility, effectiveness, and safety of allogeneic platelet-rich plasma (al-PRP) and au-PRP were investigated and compared in the treatment of DLEUs. A total of 75 in-patients with type 2 diabetes were assigned to the al-PRP group (n = 20), au-PRP group (n = 25), and conventional wound therapeutic (CWT) group (n = 30) matched by the ankle brachial index and ulcer size from December 2015 to August 2018. Based on metabolic and nutritional regulation, infective control, and topical wound management, al-PRP, au-PRP, and CWT were administered to each group, respectively. Evaluation of treatment outcomes was determined by the parameters of wound healing and adverse reactions. The therapeutic times and average concentration of platelets were not significantly different between the au-PRP and al-PRP groups. The wound healing times of the al-PRP group (56.9 ± 29.22 d) and au-PRP group (55.6 ± 33.8 d) were significantly shorter than those of the CWT group (88.0 ± 43.4 d) (P < 0.01), but there was no significant difference between the groups with PRP treatment. Although there was no significant difference in the daily healing area among all groups (P > 0.05), the trend of the healing rate in the al-PRP group (16.77 ± 12.85 mm2), au-PRP group (14.31 ± 18.28 mm2), and CWT group (9.90 ± 8.51 mm2) gradually decreased. No obvious adverse reactions (fever, edema, pain, skin itching, rash, or other sensory abnormalities) were observed in either the au-PRP or the al-PRP groups. Both al-PRP and au-PRP could effectively and safely promote wound healing in patients with DLEUs. Alternatively, al-PRP could be used for DLEUs as an off-the-shelf solution when au-PRP is limited.
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Affiliation(s)
- Min He
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China.,Department of Endocrinology, Chongqing Southwest Hospital, China.,These authors contributed equally to this article
| | - Xuewen Guo
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China.,Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, China.,These authors contributed equally to this article
| | - Tao Li
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China.,Department of Endocrinology, Chongqing Southwest Hospital, China.,These authors contributed equally to this article
| | - Xiaoyan Jiang
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China
| | - Yan Chen
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China
| | - Yi Yuan
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China
| | - Bing Chen
- Department of Endocrinology, Chongqing Southwest Hospital, China
| | - Gangyi Yang
- Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, China
| | - Yahan Fan
- Department of Blood Transfusion, Southwest Hospital, Chongqing, China
| | - Ziwen Liang
- Department of Endocrinology, Chongqing Southwest Hospital, China
| | - David G Armstrong
- Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, USA
| | - Wuquan Deng
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, China
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Brewer CF, Smith A, Miranda BH. The use of platelet-rich products for skin graft donor site healing: a systematic review and meta-analysis. J Plast Surg Hand Surg 2021; 55:133-140. [PMID: 33190577 DOI: 10.1080/2000656x.2020.1846544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/29/2020] [Indexed: 01/13/2023]
Abstract
Split thickness skin grafting is a common reconstructive technique which carries unavoidable donor site morbidity. The aim of this systematic review and meta-analysis is to present the evidence for the use of platelet rich plasma as an adjunct to donor site wound healing. A comprehensive literature search was performed, according to PRISMA guidelines from inception to August 2020, for studies regarding platelet rich plasma and skin graft donor site healing. Animal studies, case series of less than three cases and studies reporting histological outcomes only were excluded. The literature search identified 114 articles. After applying the exclusion criteria, four randomised control trials and two case-control studies remained, incorporating a total of 218 wounds in 139 patients. Four out of six studies reported total healing times for donor site wounds. Pooled analysis showed a significant reduction in healing time when donor wounds were treated with PRP versus controls [MD 5.95, 95% CI 5.04-6.85, p < 0.001]. Of the five studies which reported pain at dressing change, four showed significantly reduced pain scores for the platelet rich plasma treated wounds versus control. There were no significant complications recorded in the treated wounds. The current evidence basis for platelet rich plasma in donor site healing is limited by heterogeneous methodology and reporting outcomes and low powered studies. Nevertheless, the preponderance of data supports its use for accelerating wound healing and reducing pain at dressing change. These preliminary findings need to be substantiated with higher powered randomised controlled trials with standardised PRP manufacture and reporting structures.
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Affiliation(s)
- Christopher F Brewer
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK
| | - Alexander Smith
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK
| | - Ben H Miranda
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK
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8
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The Management of Postsurgical Wound Complications with Plasma Rich in Growth Factors: A Preliminary Series. Adv Skin Wound Care 2021; 33:202-208. [PMID: 31789622 DOI: 10.1097/01.asw.0000604168.62330.c7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Postsurgical wound complications constitute a relevant public health issue because of their frequency. There is growing evidence regarding platelet-based autologous therapies that support their use in promoting cutaneous regeneration. OBJECTIVE To provide preliminary data regarding the potential benefit of plasma rich in growth factors (PRGF) in the management of postsurgical wound complications. DESIGN Three patients suffering from poorly healing severe full-thickness wounds were treated with either one or a combination of different formulations derived from their own blood: autologous clot, fibrin membrane, injectable plasma, or topical ointment. Different treatment protocols are described, and follow-up results are reported. RESULTS Within 4 to 12 months, the treated wounds healed completely with no signs of infection, tissue necrosis, or functional impairment. No adverse events were reported. CONCLUSION Additional clinical trials with long-term follow-up periods and larger patient populations are needed to establish the efficacy of PRGF technology. However, these preliminary findings suggest that PRGF merits further randomized controlled studies exploring its capacity to accelerate re-epithelialization and restore functional integrity to cutaneous ulcers resulting from surgical complications.
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9
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Chen Z, Wu Y, Turxun N, Shen Y, Zhang X. Efficacy and safety of platelet-rich plasma in the treatment of severe burns: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2020; 99:e23001. [PMID: 33157943 PMCID: PMC7647582 DOI: 10.1097/md.0000000000023001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In recent years, platelet-rich plasma (PRP) has been used in burn wound repair, plastic surgery, bone and tendon ligament injury repair and other treatment at home and abroad. Clinical studies indicate that PRP has a good curative effect on repairing burn wounds. The residual wounds formed after large area severe burns are difficult to cure and have recurrent attacks. Because the action mechanism of PRP is unclear, its clinical efficacy of PRP in repairing severe burn wounds is controversial. And there is no relevant systematic evaluation of PRP in repairing severe burn wounds now. OBJECTIVE Meta analysis was used to evaluate the efficacy and safety of PRP in repairing severe burn wounds. METHODS Randomized controlled clinical trial of using PRP to repair severe burn wounds were retrieved by computer WanFang, China National Knowledge Infrastructure, China Science and Technology Journal Database, China Biology Medicine disc, Embase, PubMed, Web of Science and Cochrane Library from the establishment of the database to September 2020. Two researchers independently extract data and assess the quality of the included literature, and Meta analysis of the included literature is carried out by using RevMan5.3 software. RESULTS In this study, the efficacy and safety of PRP in repairing severe burn wounds are evaluated from the aspects of wound healing rate, wound healing time, scar index, visual simulation score, the number of layers of dressing, the number of times of changing gauze, frequency of dressing change, the positive rate of wound bacterial culture and the incidence of inflammatory reaction. CONCLUSIONS PRP has a good curative effect on the repair of severe burn wounds. This study provides reliable evidence for the clinical use of PRP in the clinical repair of severe burn wounds. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/FG682.
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Affiliation(s)
- Zhao Chen
- People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi830001, Xinjiang Uygur Autonomous Region
| | - Yuyan Wu
- Linqing People's Hospital, Linqing252600, Shandong province
| | - Nurlan Turxun
- People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi830001, Xinjiang Uygur Autonomous Region
| | - Yingjie Shen
- Beijing Chaoyang Hospital affiliated to Capital Medical University, Beijing, China
| | - Xue Zhang
- Beijing Chaoyang Hospital affiliated to Capital Medical University, Beijing, China
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10
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Treating pain on skin graft donor sites: Review and clinical recommendations. J Trauma Acute Care Surg 2017; 83:954-964. [DOI: 10.1097/ta.0000000000001615] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Lin SL, Wu SL, Tsai CC, Ko SY, Chiang WF, Yang JW. The Use of Solid-Phase Concentrated Growth Factors for Surgical Defects in the Treatment of Dysplastic Lesions of the Oral Mucosa. J Oral Maxillofac Surg 2016; 74:2549-2556. [DOI: 10.1016/j.joms.2016.06.183] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/23/2016] [Accepted: 06/23/2016] [Indexed: 10/21/2022]
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12
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Marck RE, Gardien KLM, Stekelenburg CM, Vehmeijer M, Baas D, Tuinebreijer WE, Breederveld RS, Middelkoop E. The application of platelet-rich plasma in the treatment of deep dermal burns: A randomized, double-blind, intra-patient controlled study. Wound Repair Regen 2016; 24:712-20. [PMID: 27169627 DOI: 10.1111/wrr.12443] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/06/2016] [Indexed: 11/30/2022]
Abstract
Platelet-rich plasma (PRP) is a fraction of blood with a platelet concentration above baseline. When platelets get activated, growth factors involved in wound healing are released. The application of PRP has shown good results in wound care, however, up to date no substantial research has been performed on the effect of PRP in burn treatment. This randomized double blind intra-patient controlled study investigates the effect of autologous PRP on wound healing in burns that require surgery with a meshed split skin graft (SSG). Fifty-two patients with various areas of deep dermal to full thickness burns, receiving surgery with a SSG were included after informed consent. Comparable study areas A and B (intra-patient) were appointed, randomized and either treated with a SSG and PRP or with a SSG alone. At day 5 to 7 postoperative, the epithelialization and graft take rate were assessed. Three, six, and twelve months postoperative, follow-up measurements were performed in the form of POSAS-questionnaires, DermoSpectroMeter, and Cutometer measurements. There was no statistically significant difference between the mean take rate nor the mean epithelialization rate at day 5-7 between the PRP-treated and control areas. However, PRP-treated wound areas showed more often better or equal epithelialization and take rates at day 5-7 than the standard treated areas. Minor effects were also seen in the reoperated and early operated subgroups. At 3, 6, and 12 months postoperative, POSAS scores from the patients and the observers, Dermaspectro-, and Cutometer measurements did not depict a significant difference between the PRP and standard treated areas. Concluding, the addition of PRP in the treatment of burn wounds did not result in improved graft take and epithelialization, nor could we demonstrate better scar quality. There was, however, a considerable variation in our clinical population.
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Affiliation(s)
- Roos E Marck
- Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center Amsterdam, The Netherlands.,Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.,Association of Dutch Burn Centers, Beverwijk, The Netherlands.,Move Research Institute VU University medical Center, Amsterdam, The Netherlands
| | - Kim L M Gardien
- Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.,Association of Dutch Burn Centers, Beverwijk, The Netherlands.,Move Research Institute VU University medical Center, Amsterdam, The Netherlands
| | - Carlijn M Stekelenburg
- Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.,Association of Dutch Burn Centers, Beverwijk, The Netherlands.,Move Research Institute VU University medical Center, Amsterdam, The Netherlands
| | | | - D Baas
- Burn Center, Red Cross Hospital, Beverwijk, The Netherlands
| | | | - Roelf S Breederveld
- Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.,Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Esther Middelkoop
- Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.,Association of Dutch Burn Centers, Beverwijk, The Netherlands.,Move Research Institute VU University medical Center, Amsterdam, The Netherlands
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13
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Pignalosa O, Martusciello D, De Pascale MR, Sommese L, Nicoletti GF, Itro A, Cavalca F, Tartaro G, Napoli C. Platelet Gel in a Non-Regenerating Cryosurgery-Induced Skin Wound in an Old Patient: A Case Report. Med Princ Pract 2016; 25:388-90. [PMID: 27165056 PMCID: PMC5588430 DOI: 10.1159/000446319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 04/20/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To report on the clinical benefits of platelet gel application in a non-regenerating skin wound. CLINICAL PRESENTATION AND INTERVENTION An 84-year-old man presented with a severe wound with a regular circumference in the frontal region which resulted in a complete loss of epidermis and dermis. The skin lesion, induced by cryosurgery used to remove a basal-cell carcinoma, had previously been treated with a dermal substitute application (Integra®). After the failure of the skin graft, the patient was treated using a platelet gel therapeutic protocol which achieved the complete healing of the injured area. CONCLUSION This case showed the clinical efficacy of using platelet gel in this elderly patient in whom the dermal substitute graft had been ineffective.
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Affiliation(s)
- Orlando Pignalosa
- Unità Operativa Complessa, Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Regional Reference Laboratory of Transplant Immunology, Department of Internal Medicine and Specialistic Unit, Azienda Ospedaliera Universitaria, Second University of Naples, Italy
| | - Dario Martusciello
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Second University of Naples, Naples, Italy
| | - Maria R. De Pascale
- Unità Operativa Complessa, Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Regional Reference Laboratory of Transplant Immunology, Department of Internal Medicine and Specialistic Unit, Azienda Ospedaliera Universitaria, Second University of Naples, Italy
| | - Linda Sommese
- Unità Operativa Complessa, Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Regional Reference Laboratory of Transplant Immunology, Department of Internal Medicine and Specialistic Unit, Azienda Ospedaliera Universitaria, Second University of Naples, Italy
- *Dr. Linda Sommese, UOC Clinical Immunology, Immunohematology, Transfusion, Medicine and Transplant Immunology, Regional Reference Laboratory of Transplant, Immunology, Department of Internal Medicine and Specialistic Unit, Azienda Ospedaliera Universitaria, Second University of Naples, Piazza Miraglia 2, IT—80138 Naples (Italy) E-Mail
| | - Giovanni F. Nicoletti
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Second University of Naples, Naples, Italy
| | - Angelo Itro
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Second University of Naples, Naples, Italy
| | - Francesco Cavalca
- Unità Operativa Complessa, Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Regional Reference Laboratory of Transplant Immunology, Department of Internal Medicine and Specialistic Unit, Azienda Ospedaliera Universitaria, Second University of Naples, Italy
| | - Gianpaolo Tartaro
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Second University of Naples, Naples, Italy
| | - Claudio Napoli
- Unità Operativa Complessa, Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Regional Reference Laboratory of Transplant Immunology, Department of Internal Medicine and Specialistic Unit, Azienda Ospedaliera Universitaria, Second University of Naples, Italy
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Shetty S, Shenoi SD. Autologous platelet-rich fibrin in treatment of scleroderma ulcer. Int Wound J 2015; 13:1065-6. [PMID: 26290396 DOI: 10.1111/iwj.12480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 07/13/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Shricharith Shetty
- Department of Dermatology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
| | - Shruthakirti D Shenoi
- Department of Dermatology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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15
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Figueiredo C, Blasczyk R. A future with less HLA: potential clinical applications of HLA-universal cells. ACTA ACUST UNITED AC 2015; 85:443-9. [DOI: 10.1111/tan.12564] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- C. Figueiredo
- Institute for Transfusion Medicine; Hannover Medical School; Hannover Germany
| | - R. Blasczyk
- Institute for Transfusion Medicine; Hannover Medical School; Hannover Germany
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