The impact of local application of platelet rich plasma on the viability of skin grafts: an experimental and clinical study

Introduction Skin grafting is one of the commonest plastic surgical procedures. Successful graft take is based on the safe adhesion and revascularization of the graft to the recipient site. Local application of platelet rich plasma (PRP) is considered to enhance healing process of tissue defects. The aim of this study is to evaluate the impact of the local use of platelet rich plasma in enhancing take of skin autografts.Material & MethodExperimental Study Full thickness skin grafts (dimensions 4x4 cm) were harvested from both ears of 20 rabbits; thus two skin defects were created in each animal. The defects over the right ear was covered with the contralateral skin graft after peroperative local platelet rich plasma (PRP) application (Group A, n=20) and the defects over the left ear was covered with the contralateral right skin graft without prior PRP application (Group B, n=20).The results were evaluated by morphological and histological study of samples taken on the seventh postoperative day. We recorded the percentage of graft take in both groups, and the new vessel formation within the grafts; we also performed statistical analysis of our results. Clinical Study Our clinical study consists of 20 patients were treated with skin grafting and simultaneous local application of platelet rich plasma (PRP) to reconstruct their skin defect. Patients’ age ranged from 19 to 72 years. Inclusion criteria of patients in this study were the presence of the least two high-risk factors, i.e. diabetes mellitus, smoking, hypertension, chronic renal failure, etc. On the fifth postoperative day the “tie-over” dressing was removed and followed by clinical evaluation of the graft take at this moment, as well as clinical follow-up in order to determine the healing time of the grafted areas in a percentage greater than 90%. Histological confirmation was also conducted at the same time.ResultsExperimental Study The morphological study concerning the graft take gave similar results in both groups. Histological reults regarding the vascular neo-formation showed that the fractional and absolute volumes of vessels were higher in group A compared to group B. This increase was statistically significant (p 90%, καθώς και ιστολογική μελέτη κατόπιν λήψης ιστοτεμαχίων από την μεταμοσχευθείσα περιοχή.ΑποτελέσματαΠειραματική ΜελέτηΤα αποτελέσματα της μορφολογικής εκτίμησης της πρόσληψης των μοσχευμάτων δεν έδειξαν σημαντική διαφορά στις δύο ομάδες μοσχευμάτων. Η ιστολογική μελέτη έδειξε ότι ο κλασματικός και απόλυτος όγκος των νεοσχηματισθέντων αγγείων των μοσχευμάτων ήταν σημαντικά αυξημένος στην ομάδα Α σε σχέση με την ομάδα Β. Η αύξηση αυτή αντιστοιχούσε σε ποσοστό 65% (p90%, ήταν 15 (+/- 5) ημέρες με διακύμανση από 5 ως 19 ημέρες.Συμπεράσματα Σύμφωνα με τα αποτελέσματα της μελέτης μας η τοπική έγχυση PRP στη δέκτρια περιοχή αυτόλογου δερματικού μοσχεύματος οδηγεί σε αύξηση της νεο-αγγειογένεσης του μοσχεύματος και σε μείωση του χρόνου ολοκλήρωσης της επούλωσης της μεταμοσχευθείσας περιοχής