Singer Adam J, Toussaint Jimmy, Chung Won Taek, McClain Steve, Raut Vivek, Rosenberg Lior
Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, United States; Department of Plastic and Reconstructive Surgery, Ben-Gurion University, Beer-Sheba, Israel.
Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, United States; Department of Plastic and Reconstructive Surgery, Ben-Gurion University, Beer-Sheba, Israel.
Burns. 2018 Sep;44(6):1543-1550. doi: 10.1016/j.burns.2018.04.021. Epub 2018 May 21.
Platelet rich plasma (PRP) is rich in growth factors and has been shown to improve healing in a variety of wounds. We determined the effects of PRP on healing and scarring in full thickness porcine burns with and without tangential excision and grafting (TEG).
Standardized full thickness 5cm by 5cm burns were created on each of the backs and flanks of 10 anesthetized female pigs (25kg) using a validated model. The burns were created with a heating device that emits heat at a temperature of 400°C for a period of 30s. The burns were randomized to one of six treatments: no TEG or PRP, no TEG+PRP, early (day 2) TEG and no PRP, early TEG+PRP, late (day 14) TEG and no PRP, and late TEG+PRP. Tangential excision was performed down to viable tissue and autografts were 0.2mm thick. When used, a thin layer of autologous PRP was applied below the graft. All wounds were then treated with a topical antibiotic ointment 3 times weekly for 42 days. Digital images and full thickness biopsies were taken at 9, 11, 14, 18, 21, 28, 35 and 42days after injury to determine percentage reepithelialization, scar depth, and scar contraction. Tissue sections were stained with H&E and viewed by a dermatopathologist masked to treatment assignment.
There was no reduction in platelet and white blood cell concentrations in PRP and blood samples for the first 14days after-full thickness burns. A total of 120 burns were created on 10 animals evenly distributed between the six treatment groups. Burns undergoing early TEG reepithelialized fastest and with the thinnest scars followed by late TEG. Burns that did not undergo TEG had the slowest reepithelialization and greatest amount of scarring. Application of PRP had no additional effects on reepithelialization, scar depth, or scar contraction in any of the treatment groups.
Addition of PRP had similar effects on reepithelialization and scarring of full thickness porcine burns as standard topical antibiotic ointment regardless of whether the burns underwent excision or grafting or the timing of excision and grafting.
富含血小板血浆（PRP）富含生长因子，已被证明可促进多种伤口的愈合。我们确定了PRP对有或无削痂植皮（TEG）的猪全层烧伤愈合和瘢痕形成的影响。
使用经过验证的模型，在10只麻醉的雌性猪（25千克）的背部和侧面创建标准化的5厘米×5厘米全层烧伤创面。使用在400°C温度下发热30秒的加热装置造成烧伤。将烧伤随机分为六种治疗方法之一：不进行TEG或PRP治疗、不进行TEG+PRP治疗、早期（第2天）TEG且不使用PRP、早期TEG+PRP、晚期（第14天）TEG且不使用PRP、晚期TEG+PRP。削痂至有活力的组织，自体皮片厚度为0.2毫米。使用时，在移植物下方涂抹一层薄薄的自体PRP。然后所有伤口每周用外用抗生素软膏治疗3次，持续42天。在受伤后第9、11、14、18、21、28、35和42天拍摄数码图像并进行全层活检，以确定再上皮化百分比、瘢痕深度和瘢痕收缩情况。组织切片用苏木精和伊红染色，由对治疗分组不知情的皮肤病理学家进行观察。
全层烧伤后的前14天，PRP和血液样本中的血小板和白细胞浓度没有降低。在10只动物身上共造成120处烧伤，平均分布在六个治疗组中。接受早期TEG治疗的烧伤再上皮化最快，瘢痕最薄，其次是晚期TEG。未接受TEG治疗的烧伤再上皮化最慢，瘢痕形成最多。在任何治疗组中，应用PRP对再上皮化、瘢痕深度或瘢痕收缩均无额外影响。
无论烧伤是否接受切除或植皮，以及切除和植皮的时机如何，添加PRP对猪全层烧伤的再上皮化和瘢痕形成的影响与标准外用抗生素软膏相似。
