Abstract
BackgroundWound healing involves complex mechanisms, which, if properly chaperoned, can enhance patient recovery. The abilities of platelets and keratinocytes may be harnessed in order to stimulate wound healing through the formation of platelet clots, the release of several growth factors and cytokines, and cell proliferation. The aim of the study was to test whether autologous keratinocyte suspensions in platelet concentrate would improve wound healing. The study was conducted at the Lausanne University Hospital, Switzerland in 45 patients, randomized to three different topical treatment groups: standard treatment serving as control, autologous platelet concentrate (PC) and keratinocytes suspended in autologous platelet concentrate (PC + K). Split thickness skin graft donor sites were chosen on the anterolateral thighs of patients undergoing plastic surgery for a variety of defects. Wound healing was assessed by the duration and quality of the healing process. Pain intensity was evaluated at day five.ResultsHealing time was reduced from 13.9 ± 0.5 days (mean ± SEM) in the control group to 7.2 ± 0.2 days in the PC group (P < 0.01). An addition of keratinocytes in suspension further reduced the healing time to 5.7 ± 0.2 days. Pain was reduced in both the PC and PC + K groups. Data showed a statistically detectable advantage of using PC + K over PC alone (P < 0.01).ConclusionThe results demonstrate the positive contribution of autologous platelets combined with keratinocytes in stimulating wound healing and reducing pain. This strikingly simple approach could have a significant impact on patient care, especially critically burned victims for whom time is of the essence.Clinical trial registry informationProtocol Record Identification Number: 132/03Registry URL: http://www.clinicaltrials.gov
Highlights
Wound healing involves complex mechanisms, which, if properly chaperoned, can enhance patient recovery
None satisfies all the criteria mentioned above, the importance of researching other tools. Specific growth factors such as platelet-derived growth factor (PDGF), epidermal growth factor (EGF) and fibroblast growth factor (FGF) have been used in topical treatments [5] but results published far are inconclusive, probably because of the complexity of the healing phenomenon which cannot be stimulated by the local application of one factor at any given time, especially since the dosages are often well above physiological levels
There were no statistically significant differences between the groups with respect to gender and age despite the platelet concentrate (PC) + K group having a ratio of female to male patients which was almost the inverse of that in other groups
Summary
Wound healing involves complex mechanisms, which, if properly chaperoned, can enhance patient recovery. None satisfies all the criteria mentioned above, the importance of researching other tools Specific growth factors such as platelet-derived growth factor (PDGF), epidermal growth factor (EGF) and fibroblast growth factor (FGF) have been used in topical treatments [5] but results published far are inconclusive, probably because of the complexity of the healing phenomenon which cannot be stimulated by the local application of one factor at any given time, especially since the dosages are often well above physiological levels. Even with increased precision in surgical technique, post-operative smart dressings, administration of growth factors and regular use of nutritional supplements, reported healing time and risk of complications remained unchanged [9,10], resulting in inconsistent and disappointing outcomes with dissuasive treatment costs
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