Dataset Information

Regenerative Wound Healing by Open Grafting of Autologous Fat and PRP-Gel - A New Concept and Potential Alternative to Flaps.

ABSTRACT: A new regenerative technique is described that enabled in situ formation of soft tissue bridge for difficult wounds, which otherwise needed flaps, resulting in complete healing in 3/3 cases. The wounds were debrided till healthy bleeding and covered with a triple-layer matrix of platelet-rich fibrin gel, condensed liposuctioned autologous fat, and porous collagen dressing. Negative pressure wound therapy was applied after 48 hours for 4-5 days in 2 cases and after 11 days for 3 weeks in the third case. Rapid vascularization was noted, with regeneration of mature tissue bridge and subsequent epithelization even over the bone. One patient underwent elective replacement of healed epithelium by split skin graft for better aesthetics and durability. This technique, if further validated, may herald a new concept of in situ regeneration, namely transformation of autologous tissue (grafted in gel form) to viable soft tissue.

SUBMITTER: Rangaswamy M

PROVIDER: S-EPMC7859317 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Regenerative Wound Healing by Open Grafting of Autologous Fat and PRP-Gel - A New Concept and Potential Alternative to Flaps.

Rangaswamy Mohan M

Plastic and reconstructive surgery. Global open 20210125 1

A new regenerative technique is described that enabled in situ formation of soft tissue bridge for difficult wounds, which otherwise needed flaps, resulting in complete healing in 3/3 cases. The wounds were debrided till healthy bleeding and covered with a triple-layer matrix of platelet-rich fibrin gel, condensed liposuctioned autologous fat, and porous collagen dressing. Negative pressure wound therapy was applied after 48 hours for 4-5 days in 2 cases and after 11 days for 3 weeks in the thir ...[more]

PMID: 33564580

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Project description:ObjectiveTo summarise evidence on the effectiveness of Platelet-Rich Plasma (PRP) gel and Leucocyte and Platelet Rich Fibrin (L-PRF) gel as agents promoting ulcer healing compared with the standard wound dressing techniques alone.DesignSystematic review.Eligibility criteriaIndividual patient randomised controlled trials on skin ulcers of all types excluding traumatic lesions.Intervention group: treatment with topical application of L-PRF gel or PRP gel to the wound surface.Control grouptreatment with standard skin ulcer care using normal saline, normgel or hydrogel dressings.Information sourcesMedline (Ovid), Excerpta Medica Database (EMBASE), Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science and manual search of studies from previous systematic reviews and meta-analyses. The papers published from 1946 to 2022 with no restriction on geography and language were included. The last date of the search was performed on 29 August 2022.Data extraction and synthesisIndependent reviewers identified eligible studies, extracted data, assessed risk of bias using V.2 of the Cochrane risk-of-bias tool for randomised trials tool and assessed certainty of evidence by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.Main outcome measuresTime to complete healing, proportion healed at a given time and rate of healing.ResultsSeven studies met the inclusion criteria, five using PRP gel and two using L-PRF gel. One study showed a better proportion of complete healing, three reported reduced meantime to complete healing and five showed improved rate of healing per unit of time in the intervention group. The risk of bias was high across all studies with one exception and the GRADE showed very low certainty of evidence.ConclusionThe findings show potential for better outcomes in the intervention; however, the evidence remains inconclusive highlighting a large research gap in ulcer treatment and warrant better-designed clinical trials.Prospero registration numberCRD42022352418.

Dataset Information

Regenerative Wound Healing by Open Grafting of Autologous Fat and PRP-Gel - A New Concept and Potential Alternative to Flaps.

Publications

Regenerative Wound Healing by Open Grafting of Autologous Fat and PRP-Gel - A New Concept and Potential Alternative to Flaps.

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