Use of platelet rich plasma and split thickness skin graft in post-infection soft tissue defects, our initial experience

Abstract

Introduction. Necrotizing soft tissue infections (NSTI) are severe, potentially life-threatening medical emergencies that are accompanied with devastating and rapidly spreading destruction of soft tissue as a result of bacterial infection and systemic toxicity. Patients with NSTI who undergo split thickness skin graft (STSG) experience high rates of complications. Platelet-rich plasma (PRP) has shown to have positive effect on the healing of acute, chronic and diabetic wounds. The aim of this study was to analyze the outcome of skin grafting with PRP in post-infectious soft tissue defects. Materials and Methods. Fourteen patients were randomized in two groups: an experimental group – wound coverage with STSG and PRP, and control group – with STSG alone. PRP was applied to the donor site in the experimental group. Patients’ follow up was until complete healing of wounds. In both groups we analyzed the healing time, the need for regrafting, secondary infections, pain and adverse effects. Results. Patients in the PRP group have had significantly reduced healing time (32.5 days) versus control group (72.5 days). In the experimental group, the rate of skin graft success was 90.2% vs. 77.2% in the control group. The need for regrafting occurred in one patient in the control group. Pain at the donor site in experimental group was statistically significantly lower. No adverse effects were reported. Conclusion. The combination of STSG and PRP reduces healing time and lowers the complication rates. It is safe to use with no adverse effect. Further studies are needed with larger number of patients to further validate its efficacy