Barbara Hersant1, Mounia SidAhmed-Mezi, Romain Bosc, Jean-Paul Meningaud. 1. Barbara Hersant, MD, is a Plastic Surgeon; Mounia SidAhmed-Mezi, PhD, is a Researcher; Romain Bosc, MD, is a Plastic Surgeon; and Jean-Paul Meningaud, MD, PhD, is Chief, Department of Plastic Cosmetic and Reconstructive Surgery, and is a Plastic and Maxillo-facial Surgeon, Henri Mondor Hospital, Paris, France.
Abstract
BACKGROUND: Managing cutaneous substance loss after debridement is challenging, especially if it is secondary to necrotizing soft tissue infection, such as necrotizing fasciitis and Fournier gangrene. After skin graft reconstruction, the healing process is longer and may be difficult, depending on the wound site, skin defect size, and patient comorbidities. OBJECTIVE: The aim of this study was to investigate whether autologous platelet-rich plasma (A-PRP) could accelerate and improve wound healing after cutaneous reconstruction for tissue loss secondary to soft tissue infection. METHODS AND MATERIALS: A prospective, controlled, randomized, open-label study was conducted. Patients (N = 27) were randomized into 2 groups by drawing lots using sealed envelopes: an experimental (n = 14) and a control group (n = 13). Initially, all the necrotic tissue was extensively debrided and excised. In the experimental group, patients underwent a split-thickness skin graft (STSG) combined with A-PRP/thrombin gel sprayed on the wound bed and on the STSG after staple fixation. In the control group, patients underwent an STSG alone. RESULTS: Results showed that the mean complete healing time was significantly reduced (by almost 50%) when A-PRP/thrombin gel was combined with an STSG compared with STSG alone (37.9 [SD, 14.3] days in the experimental group vs 73.7 [SD, 50.84] days in the control group, P = .01). No patient experienced complications during the follow-up period. CONCLUSION: The combination of A-PRP/thrombin gel and an STSG significantly improved clinical outcomes and shortened the wound healing time. Therefore, this treatment combination could provide a way to heal skin after a necrotizing soft tissue infection with minimal recovery time.
RCT Entities:
BACKGROUND: Managing cutaneous substance loss after debridement is challenging, especially if it is secondary to necrotizing soft tissue infection, such as necrotizing fasciitis and Fournier gangrene. After skin graft reconstruction, the healing process is longer and may be difficult, depending on the wound site, skin defect size, and patient comorbidities. OBJECTIVE: The aim of this study was to investigate whether autologous platelet-rich plasma (A-PRP) could accelerate and improve wound healing after cutaneous reconstruction for tissue loss secondary to soft tissue infection. METHODS AND MATERIALS: A prospective, controlled, randomized, open-label study was conducted. Patients (N = 27) were randomized into 2 groups by drawing lots using sealed envelopes: an experimental (n = 14) and a control group (n = 13). Initially, all the necrotic tissue was extensively debrided and excised. In the experimental group, patients underwent a split-thickness skin graft (STSG) combined with A-PRP/thrombin gel sprayed on the wound bed and on the STSG after staple fixation. In the control group, patients underwent an STSG alone. RESULTS: Results showed that the mean complete healing time was significantly reduced (by almost 50%) when A-PRP/thrombin gel was combined with an STSG compared with STSG alone (37.9 [SD, 14.3] days in the experimental group vs 73.7 [SD, 50.84] days in the control group, P = .01). No patient experienced complications during the follow-up period. CONCLUSION: The combination of A-PRP/thrombin gel and an STSG significantly improved clinical outcomes and shortened the wound healing time. Therefore, this treatment combination could provide a way to heal skin after a necrotizing soft tissue infection with minimal recovery time.
Authors: Syed Sarim Imam; Fahad A Al-Abbasi; Salman Hosawi; Muhammad Afzal; Muhammad Shahid Nadeem; Mohammed M Ghoneim; Sultan Alshehri; Sami I Alzarea; Ali Alquraini; Gaurav Gupta; Imran Kazmi Journal: Regen Ther Date: 2022-02-15 Impact factor: 3.419