Objective:

To compare the percentage of adhesion and clinical course in patients with third degree burns treated with autologous free meshed thin skin graft plus the use of activated allogeneic platelet rich plasma in relation to whom activated platelet rich plasma was not applied and then were given 0.9% physiological solution as a placebo.

Material and methods:

From February to May 2016, 10 patients who were treated at the Hospital General del Estado de Chihuahua Burn Unit. They were studied with third degree burns below 35% of total body surface area. All were candidates for treatment with a free mesh skin graft. Five patients were randomly assigned to treatment with activated platelet rich plasma and the other five patients were assigned to a placebo with 0.9% saline solution as an aggregate treatment. An injector sample is taken with Padgett electric dermatome, and a 3: 1 Brennen skin graft mesh was used. the platelet concentrate at a rate of 1 cc per 4 cm2 of graft surface, mix with bovine thrombin 28 U/ml and calcium gluconate 2.8 mg/ml, wait 5 minutes for the platelets to evacuate, dissolve the coagulum formed with a blunt instrument, the resulting mixture is taken with a 10 cc syringe and No. 23 needle and it is infiltrated in a surgical bed in 0.5 cc subcutaneous tissue with a separation of 2 cm in the longitudinal and lateral direction.

Results:

In the group of patients treated with allogeneic activated platelet-rich plasma (PRPAA), the clinical adhesion of the graft was 100% compared to the 92% average of the placebo group. 20% of positive cultures for infection in the case group vs 80% with positive cultures of the control group. Histopathologically, a lower epithelialization was found in the placebo group on the fifth day of graft placement vs the PRPAA group, where increased thickness in the corneal layer was observed, neovascularization vessels increased per field and the granulomatous reaction.

Conclusions:

The use of PRPAA in patients with third-degree burns who undergo a free-cut, thin-skinned graft shows advantages in the clinical course, via the percentage of adhesion and decrease in infection vs patients treated with a placebo.

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