Evaluation of the Effect of Platelet-Rich Plasma on Post-Burn Scars

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Case Report
Volume 5 Issue 2 - August 2017
DOI: 10.19080/OAJS.2017.05.555660
Open Access J Surg
Copyright © All rights are reserved by Malek Ahmed Mohamed Elsayed
Evaluation of the Effect of Platelet-Rich Plasma
on Post-Burn Scars
Malek Elsayed*, Mohamed Abdel Moaty, Amr Moghazy and Omar Salah Eldeen
Surgery Department, Suez Canal University Hospitals, Faculty of Medicine, Suez Canal University, Egypt
Submission: August 06, 2017; Published: August 16, 2017
*Corresponding author: Malek Ahmed Mohamed Elsayed, Department of Surgery, Plastic Surgery Unit, Suez Canal University Hospitals, Ismailia,
Egypt, Tel: ; Email:
Open Access J Surg 5(2): OAJS.MS.ID.555660 (2017) 001
Introduction
The healing process comprehends four stages, namely:
      
  
[1]. Following the injury, platelets are stimulated to aggregate
and to secrete growth factors, cytokines and other homeostatic
factors required for clotting cascade which characterize,

         
      
   
to the place of wound, such as leukocytes, macrophages and
neutrophils, which act on the phagocytosis of the products
resulting from the cellular lysis [3] When this stage is over, the
       
        
[1].
Residual epithelial cells or those which have migrated to
the injured area multiply themselves and form scars. The scar

       
   
  
only growth factors deriving from platelets themselves were


use of autologous PRP as an additional element for transfusion
in cardiac surgeries, for the purpose of eliminating the use of
homologous products. However, in the 90’s decade PRP started
   
mainly in the areas of dentistry and orthopedics [6].

       
Abstract
Introduction                

Objectives                 


Methods     
        


Results             


Conclusion
use of this treatment.
Keywords

How to cite this article: Malek E, Mohamed A M, Amr M, Omar S E. Evaluation of the Effect of Platelet-Rich Plasma on Post-Burn Scars. Open Access
J Surg. 2017; 5(1): 555660.DOI: 10.19080/OAJS.2017.05.555660.
002
Open Access Journal of Surgery
concentration of growth factors and secretion of proteins which


   


      
 
      
cells, such as monocytes and leukocytes, in the injury site.
   
mediated process seems to result from the control of the local

    

         
many clinical studies, particularly in periodontal surgery,
orthopedics and trauma surgery, and plastic surgery [8]. Despite
    

scars treatment, during the maturation and remodeling phases,
using PRP. Therefore, the purpose of this study is to evaluate


Methods
Subjects
The current prospective randomized clinical controlled
trial was conducted at the outpatient clinic of plastic surgery
of Suez Canal University Hospitals, Faculty of Medicine, Suez

2017 after the approval of the Research Ethical Committee

A written informed consent for treatment together with

        
  
The selection of the patients in this study was done according to
the following criteria:
a. Inclusion Criteria
 
        
and scar location.
iii. Scars ranged from 2cm to 15 cm in diameter.
 
v. Patients signed the informed consent form prior to
participation.
 
      
   
recent fever condition, anemia, cancer.
ii. Patients with skin lesions in the area of the injection.
iii. Current intake of oral anticoagulants, platelet

   



2 involved 19 patients who treated as a control group with

        
  

Procedure
       
data, preoperative, intraoperative and postoperative evaluation.
All patients were interviewed and their personal data taken, and
        

        






intermediate zone.
           

   

 
     
     
     
  
 


          

the upper part, consisting of PPP; and the lower part, consisting
           
  
   
Figure 1 in the proportion of 0.1 mL per 0.9 mL of PRP. The PRP


How to cite this article: Malek E, Mohamed A M, Amr M, Omar S E. Evaluation of the Effect of Platelet-Rich Plasma on Post-Burn Scars. Open Access
J Surg. 2017; 5(1): 555660.DOI: 10.19080/OAJS.2017.05.555660.
003
Open Access Journal of Surgery
Figure 1: Calcium Gluconate for PRP activation.
Figure 2: Prepared PRP for injection.
Patients with group 1 treated with one session of PRP

   

solution administered using a “linear retrograde and fanning”
technique with two or three retrograde injections, called
       
  
The “tunnelling” technique takes advantage of the restoration of
the mild trauma provoked.
   
application for at least three months. Silicone gel or sheeting
applied over the scars and maintained for at least three months.
        
       
washing twice daily. Use of Silicone gel in cream or ointment

areas, use on the face, or in hot humid climates [9]. Treated areas
gently massaged and molded with hydrating cream after each
session. After the treatment the patients returned to normal

same day; at departure they used emollient creams and creams

1, 3, 6 months.
Results
 
    

PRP intralesional injection and the other group was treated as



    
   
         


Figure 3: Changes in Observer Scar Assessment Scale in PRP
group.
Figure 4: Changes in Patient Scar Assessment Scale in PRP
group.
Figure 5: Changes in Observer Scar Assessment Scale in
Silicone group.
The results were evaluated one month after the last session
     
         
       
 
          
assessment among PRP group, it shows quite improvement of


How to cite this article: Malek E, Mohamed A M, Amr M, Omar S E. Evaluation of the Effect of Platelet-Rich Plasma on Post-Burn Scars. Open Access
J Surg. 2017; 5(1): 555660.DOI: 10.19080/OAJS.2017.05.555660.
004
Open Access Journal of Surgery
and 2.2 respectively, the least improvement of these parameter
was thickness with 1.0 mean difference. All results were
   
parameters of the of the patients assessment among PRP group,
it shows quite improvement of color, itching and relief with mean

these parameter were pain and thickness with 1.6 and 1.9 mean

Figure 6: Changes in Patient Scar Assessment Scale in Silicone
group.
Figure 7: Changes in OSAS, PSAS and POSAS in PRP group.
Figure 8: Changes in OSAS, PSAS and POSAS in Silicone
group.
Regarding the Silicone group, Figure 5 shows the improvement
          
        
difference 1.8 and 1.7 respectively, the least improvement of
these parameter was pigmentation with 0.7 mean difference. All
       
improvement of the parameters of the of the patient assessment,
it shows quite improvement of thickness and relief with mean
       
of these parameter was color with 0.6 mean difference. All
        

PRP and Silicone groups.
Cases
Case 1
 


Figure 9: Case 1.
Figure 10: Case 2.
       
with one month interval.
Discussion
       

treatment protocol. Laser, surgery, radiotherapy, Silicone gel
     
        

          
different studies is usually small and the techniques used are
not standardized [11]. Different platelet concentrations are
       

cicatrization [12]. The increase in the rotation force is known to
provide a higher platelet concentration; however, too high forces
may lead to the loss of growth factors in the supernatant plasma
due to an early activation of the platelets and to the rupture of
         
[13].

How to cite this article: Malek E, Mohamed A M, Amr M, Omar S E. Evaluation of the Effect of Platelet-Rich Plasma on Post-Burn Scars. Open Access
J Surg. 2017; 5(1): 555660.DOI: 10.19080/OAJS.2017.05.555660.
005
Open Access Journal of Surgery
       
        
      
        
the maintenance of platelet integrity and effective activation
of the material, which often are not elucidated in the studies.

   

         
          

          
        
capillary activity and thus local collagen deposition.
According to this study, treatment of patients with post
        
         
       


of the scar. We are aware of limitations of this study, namely

        
        
application.
Conclusion
According to the study results, treatment of patients with

         
       



        
potential use of this treatment.
References
1.             
        

2. 
  

3.          
         

   

5. 
    
5160.
6.            
   
   

7.           
        

8.     
         in
vitro
9.             
Updated international clinical recommendations on scar management:
       

10. 
Scales and Scar Measuring Devices. Eplasty 10.
11.             
Tissue engineered strategies for skeletal muscle injury. Stem Cell Int
2012:175038.
12.             
Autologous platelets have no effect on the healing of human Achilles


13.          

  

15. 
of hydrocolloid dressing in the treatment of hypertrophic scars and

16. 
scars? A hypothesis. Surgery 108: 122.
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DOI: 10.19080/OAJS.2017.04.555660