EJMS

Abstract

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 1st group, the traditional methods of graft fixation were performed, while in the 2nd 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.