A Retrospective Study on the Use of Dermis Micrografts in Platelet-Rich Fibrin for the Resurfacing of Massive and Chronic Full-Thickness Burns.

Alessandro Andreone,Daan Den Hollander

doi:10.1155/2019/8636079

Abstract

The coverage of massive burns still represents a big challenge, even if several strategies are to date available to deal with this situation. In this study, we describe the use of a combination of platelet-rich fibrin and micrograft spray-on skin in order to increase the yield of grafted cells in patients. We treated a total of five patients, of which two were affected by massive burns and three with chronic burn wounds. Briefly, autologous micrografts were obtained by Rigenera technology using a class I medical device called Rigeneracons. The micrografts were then combined with PRF and sprayed on the wound bed by a Spraypen. Before applying PRF/micrograft spray-on skin, the wound bed was covered with an Integra® dermal template, and the wounds were dressed with a layer of antimicrobial dressing applied directly over the silicone layer. When the silicone layer of the dermal template started showing signs of separation, the wound was considered ready for grafting. In all cases, we observed a fast and complete skin graft on average after 7-10 days by PRF/micrograft spray-on skin treatment. In particular, two patients with massive burns reported rapid reepithelialization, and three patients with chronic burn wounds, two of whom had failed skin grafts before the procedure, had complete wound healing within a week. In conclusion, the results showed in this study suggest that the use of PRF/micrograft spray-on skin represents a promising approach in the management of burns or chronic burn wounds.

Highlights

The coverage of massive burns is a challenge
We recently developed a technique in which autologous micrografts are combined with platelet-rich fibrin and sprayed on the wound bed, in order to increase the yield of grafted cells
We describe the combined use of autologous micrografts in platelet-rich fibrin (PRF) to treat five consecutive patients affected by burns

Summary

Introduction

As about 80% of the skin can be used as possible donor sites, the area to be grafted in massive burns often exceeds the available donor skin. Cultured epithelial grafts take about 3 weeks to be cultured, and recently an affordable technique has been developed [1], long-term results remain poor. Common to all these strategies is that complete coverage of the burn wound takes time, during which period the patient is at risk of burn wound infection, sepsis, and death. Spray-on skin cells (suspended epithelial cells) are an alternative for these patients [2, 3]. One problem with the use of spray-on cells has been that when the cells are suspended in a lowviscosity solution such as normal saline, they tend to be

Methods

Results

Conclusion