Effectiveness of Autologous Platelet-Rich Plasma and Stromal Vascular Fraction in Autologous Skin Grafting

Abstract

   Introduction: Despite the medical advances, burns remain a serious challenge and require new and promising treatment options, such as biomedical technologies with a high potential for burn wound treatment. However, high cost and complexity of biotechnologies limit their routine use, but autologous tissues, such as stromal vascular fraction (SVF) and autologous platelet-rich plasma (PRP), overcome these shortcomings.   Objective: To demonstrate a successful case of using a combination of adipose-derived SVF and autologous PRP during autologous skin grafting in a severely burned patient.   Material and methods: We present a successful case of 84-year-old Patient B. treated at Saint Petersburg I. I. Dzhanelidze Research Institute of Emergency Medicine in September-October 2022. He was diagnosed with a 11% (6%) / II-III degree flame burn of the head, neck, trunk, and upper extremities and first-degree inhalation injury. At the first stage, the general condition of the patient was stabilized, and he was prepared for surgery. At the second stage, on day 25 of treatment we performed skin grafting using split-thickness autografts with rare perforations and application of SVF and autologous PRP on a burn wound. We evaluated the treatment effectiveness using planimetry, cytology, and histology.   Results: We observed complete engraftment of the autograft with no lysis or rejection during the first dressing change on day 3 after surgery and complete skin restoration on day 11. Cytologic findings over time showed an active decrease in inflammatory cells and an increase in regenerative cells, indicating successful wound healing. Histology demonstrated formation of normal stratified squamous epithelium with areas of hyperkeratosis and young granulation tissue in the superficial layers of the dermis on day 6.   Conclusions: Our case demonstrated that the combination of SVF and autologous PRP facilitates split-thickness skin autograft engraftment.