Treatment of patients with donor site wounds characterized by prolonged healing process
DOI:
https://doi.org/10.11603/2414-4533.2021.2.12085Keywords:
burns, donor site wounds, complications, platelet-rich plasma, skin graftingAbstract
The aim of the work: to substantiate the effectiveness of injectable use of platelet-rich plasma in the treatment of donor site wounds with prolonged healing process in patients with deep thermal burns.
Materials and methods. The study involved 15 patients with IIb-III degree burns with the area of 10–15 % of the body surface. Starting from (27.3±0.1) days after the injury, depending on the chosen method of local treatment, patients were divided into two groups. Dressings applied to 5 patients of the main group, in addition to treatment of the wound surface with 0.02 % decamethoxine solution, provided for daily injection of autologous platelet-rich plasma on the periphery and directly into the donor site wounds for 6–7 days. The remaining agent was applied to the wound defect, which was covered with a double layer gauze napkin impregnated with the same antiseptic and Polyvinyl chloride film with adhesive tapes as fixation, gauze bandage. Local treatment of donor site wounds of 10 patients in the control group was limited to dressings with the use of the same antiseptic solution.
Examination of the patients included visual inspection of the injured area, determination of wound defect area, microbiological and cytological examination of the wound contents.
Results and Discussion. The results of the study allowed to establish positive effect of autologous platelet-rich plasma, already on the 3rd day of observation, manifested by color change, better structure of granulation tissue, active epithelialization processes in the form of islets on the wound surface and growth on the edges, approximation of the cytological picture to the inflammatory-regenerative type. Subsequently, rapid decrease in the size of the wound defect, appearance of new cell forms with almost complete healing by (9.3±1.2) days after plasma administration was noted in the patients of the main group. Treatment of the patients in the control group by a traditional way eventually led to repeated skin grafting.
References
Sibbald, R.G., & Ayello, E.A. (2019). Deep burns: Comparing the developed and developing world. Advances in Skin & Wound Care, 32 (1), 5. Retrieved from: https://doi.org/10.1097/01.ASW.0000550458.48419.d5.
Atyasov, N.I. (1989). Lechenie ran donorskikh uchastkov pri svobodnoy kozhnoy plastike u obozhzhennykh [Treatment of donor sites wounds after split thickness grafting in patients with burns]. Saransk: MGU [in Russian].
Higgins, L., Wasiak, J., Spinks, A., & Cleland, H. (2012). Split-thickness skin graft donor site management: a randomized controlled trial comparing polyurethane with calcium alginate dressings. Int. Wound J., 9 (2), 126-131. Retrieved from: https://doi.org/10.1111/j.1742-481X.2011.00867.x.
Marck, R.E., Gardien, K.L., Stekelenburg, C.M., Vehmeijer, M., Baas, D., Tuinebreijer, … Middelkoop, E. (2016). The application of platelet-rich plasma in the treatment of deep dermal burns: A randomized, double-blind, intra-patient controlled study. Wound repair and regeneration: Official publication of the Wound Healing Society [and] the European Tissue Repair Society, 24 (4), 712–720. Retrieved from: https://doi.org/10.1111/wrr.12443.
Zhang, W., Guo, Y., Kuss, M., Shi, W., Aldrich, A. L., Untrauer, … Duan, B. (2019). Platelet-Rich Plasma for the Treatment of Tissue Infection: Preparation and Clinical Evaluation. Tissue engineering. Part B, Reviews, 25 (3), 225-236. https://doi.org/10.1089/ten.TEB.2018.0309.
Ilyukhin, E.A., Bulatov, V.L., Galchenko, M.I. (2020). Tochnost i vosproizvodimost izmereniya ploshchadi fantomnykh porazheniy kozhi nepravilnoy formy s pomoshchyu mobilnogo prilozheniya LesionMeter [Reliability and accuracy of measuring the surface area of phantom skin lesions with Lesion Meter mobile application]. Flebologiya – Phlebology, 14 (4), 266-274. Retrieved from: https://doi.org/10.17116/flebo202014041266 [in Russian].
Shelkova, N., & Prokopets, V. (2008). Metod kilkisnoho doslidzhennia vmistu bakterii u klinichnykh materialakh, shcho vidibrani za dopomohoiu vatnoho tamponu [Quantitative research method of maintenance of bacteria in clinical species which are selected by waddin tampon]. Collection of Scientific Works of Staff Member of P.L. Shupyk NMAPE, 17 (2), 698-702 [in Ukrainian].
Pokrovskaya, M.P., & Makarov, M.S. (1942). Tsitologiya ranevogo ekssudata kak pokazatel protsessa zazhivleniya rany [Cytology wound exudate as an indicator of the process of wound healing]. Moscow: Medgiz [in Russian].
Golovatenko-Abramova, P.K., Zhirkovab, E.A., Kolokolchikovab, E.G., Bocharovab, V.S., & Platonova E.S. (2010). Dermalnye kisty uchastvuyut v reparativnoy regeneratsii epidermisa u myshey genotipa Hrhr/Hrhr [Dermal cysts participate in reparative regeneration of epidermis in Hrhr/Hrhr mice]. Ontogenez – Ontogenesis, 41 (4), 285-291 [in Russian].
Brown, J.E., & Holloway, S.L. (2018). An evidence-based review of split-thickness skin graft donor site dressings. International Wound Journal, 15 (6), 1000-1009. Retrieved from: https://doi.org/10.1111/iwj.12967.
Dornseifer, U., Lonic, D., Gerstung, T.I., Herter, F., Fichter, A.M., Holm, C., … Ninkovic, M. (2011). The ideal split-thickness skin graft donor-site dressing: a clinical comparative trial of a modified polyurethane dressing and aquacel. Plastic and Reconstructive Surgery, 128 (4), 918-924. Retrieved from: https://doi.org/10.1097/PRS.0b013e3182268c02.
Zinoviev, E.V., Osmanov, K.F., Zhilin, A.A., Vinogradov, Y.V., & Almazov, I.A. (2013). Obosnovanie odnomomentnogo primeneniya chastotno-modulirovannogo signala i ranevykh pokrytiy v kompleksnom lechenii donorskikh ran posle autodermoplastiki [The rationale for the use simultaneously frequency-modulated signal and wound coverings in complex treatment of the donor wounds after autodermaplasty]. Fundamentalnye issledovaniya – Fundamental Research, 12-3, 483-485 [in Russian].
Povoroznik, A.N. (2008) Effektivnost lecheniya donorskikh ran v usloviyakh vlazhnoy kamery s ispolzovaniem biogalvanizatsii [Efficacy of donor site treatment in a humid chamber using biogalvanisation]. Vestnik neotlozhnoy i vosstanovitelnoy meditsiny – Bulletin of Emergency and Recovery Medicine, 3, 326-328 [in Russian].
Kraynyukov, P.E., Zinovev, E.V., & Osmanov, K.F. (2018). Osobennosti klinicheskoy kartiny i rezultaty lechenia donorskikh ran posle autodermoplastiki u postradavshikh ot ozhogov [Features of the clinical picture and results of treatment of donor wounds after autodermoplasty in victims of burns]. Vestnik nats. med. khirurg. tsentra im. N.N. Pirogova – Bulletin of N. N. Pirogov National Medical and Surgical Center, 13 (2), 113-117.
Sarkisov, D.S., Glushchenko, E.V., Gurukov, Sh.R., Morozov, S.S., Tumanov, V.P., & Berezhkov, N.V. (1991). Allotransplantatsiya kultivirovannykh fibroblastov na nezazhivayushchie rany posle autodermoplastiki [Allotransplantation of cultured fi broblasts on non-healing wounds after autodermatoplas]. Byull. eksp. biol. med. – Bulletin of Experimental and Biological Medicine, 111 (5), 542-544 [in Russian].
Mao, H.S., Wang, Y.P., Wang, Q., Jiang, W.Z., Zhan, W.B., Ma, J.Z., & Qiu, X.G. (2021). [Prospective randomized controlled study on clinical effects of autologous skin paste in repairing medium-thickness skin donor site wounds]. Chinese Journal of Burns, 37 (3), 232-236. Retrieved from: https://doi.org/10.3760/cma.j.cn501120-20200304-00121.
Sonker, A., Dubey, A., Bhatnagar, A., & Chaudhary, R. (2015). Platelet growth factors from allogeneic platelet-rich plasma for clinical improvement in split-thickness skin graft. Asian Journal of Transfusion Science, 9 (2), 155-158. Retrieved from: https://doi.org/10.4103/0973-6247.162712.
Brewer, C.F., Smith, A., & Miranda, B.H. (2020). The use of platelet-rich products for skin graft donor site healing: a systematic review and meta-analysis. Journal of Plastic Surgery and Hand Surgery, 1-8. Advance online publication. Retrieved from: https://doi.org/10.1080/2000656X.2020.1846544.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Hospital Surgery. Journal named by L.Ya. Kovalchuk
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).