A Pilot Study of Making New Skin and Appendages for Post Burn Scars through a Unique Cocktail of Platelet Rich Plasma, Ablative Pixel Erbium: Yag Laser and Micro Needling Radiofrequency

Abstract

Burn scars are one of the most resistant and disfiguring scars to be treated by cosmetic and plastic surgery. The challenge remains not only with the damaged top layer but also with singeing and ablation of underlying appendages, vessels, nerves and glandular tissues depending upon the depth and degree of burns. Aim: To improve structural and cosmetic outcome of a burn scar with a cocktail of platelet rich plasma therapy, ablative Pixel Erbium: YAG laser and micro needling. Methods: Five patients of post burn scars were selected for a cocktail treatment of pixel Erbium: YAG laser(Alma lasers, Harmony Platform; 1300mj/p, 5 passes), micro needling radiofrequency (De age: 3mm depth at 35w output, 3 passes) and platelet rich plasma therapy (Two Renew cell kits containing total 27 ml of whole blood). Micro needling radiofrequency was done first followed by instillation of platelet rich plasma (.05ml at a gap of 0.5 cm) each through insulin syringe and ablative laser was done last of all under local anesthesia cream. The sessions were repeated every three weeks for total 3 sessions. Results: There were 2 males and 3 females with post burns scars and all 5 patients completed the study. The scars were assessed using the POSAS (Patient and Observer Scar Assessment Scale). All patients were assessed for the improvement in pigmentation, vascularity, relief in terms of skin texture, thickness, pliability in a scale of 0-10 and also for the appearance of hair follicles (yes/ no). Maximum improvement of 3.8 points was noted in mean values of pigmentation, while thickness and vascularity showed a difference of 1.4 points each in the mean value. The values obtained in Patient Scar Assessment Scale based on the questionnaire are maximum improvement of 4.2 points was seen in mean values of Colour, while mean values of Pain showed improvement of 1.2 points. There was appearance of new hair follicles in 4 out of 5 patients. Conclusion: Platelet rich plasma cocktail can help in creating new skin by resurfacing old scarred skin, rejuvenating dermis and sub cutis, activating dormant hair follicles and forming new vessels and nerves by repairing damaged appendages.