Background: The Platelet-rich plasma
(PRP) used widely in several clinical
settings. It is well recognized for its
adhesive, hemostatic, and healing
properties. These properties of PRP
are owing to the several growth factors elaborated from the platelets into
the wound environment. However, its
useful outcome on the split-thickness
skin graft (STSGs) is quite debatable.
Aim The aim of this work is to assess
the process of wound healing histopathologically in STSG after injection
of PRP to the recipient bed compared
to the traditional method of graft fixation to determine if PRP could improve STSG outcomes.
Patients and Methods: the study incorporated 60 patients had a large skin
defect in the lower limb, with age
ranging from 19-61 years old. Of these
patients, 32 males and 28 females. The
cause of these raw areas was trauma
in 25 patients, tumor excision in 13
Patients, burn in 11 patients and
chronic ulcer in 11 patients. Patients
were allocated sequentially into one of
the two groups. In the 1
st
group, the
traditional methods of graft fixation
were performed, while in the 2
nd
group, an autologous PRP was applied
to wound beds prior to graft fixation.
Two weeks after surgery, 2 rectangular punches were biopsied from the
graft in both groups and sent for histopathology examination. The collected
data were statistically analyzed.
Results: Application of PRP to the
recipient bed prior to graft fixation
improve the STSG outcomes as we
found all the histopathological criteria
of wound healing process (epidermal
thickness, migration of keratinocytes,
bridging cells, keratinization, melanin
pigmentation, collagen fiber deposition and newly formed vessels in the
dermis with inflammatory cells) were
superior and statistically significant in
the PRP group compared to the traditional group.
Conclusion: in the present study, we
introduced the histological evidence
that confirms the application of PRP
may become an optimal choice to improve STSG outcomes. |
