The efficiency of platelet rich plasma (PRP) on salvaging zone of stasis in burns

Burn has been one of the most important problems of mankind since early ages. Burn treatment is complicated, expensive, and painful for patients. Burn also results in cosmetically undesirable scars and serious lost time injury. According to the development on understanding pathophysiology of burn, zones are described. Based on these zones, burn treatment is configured. These zones are coagulation, stasis and hyperemia zones. The hyperemia zone can heal without any treatment. The coagulation zone should be debrided and grafted over the skin defect. The appropriate management of the stasis zone in the first 24-48 hours results in full recovery. If this can not be achieved, necrosis can occur as a result of prolonged ischemia, inflammation and apoptosis. In this study platelet rich plasma (PRP) is used as a savior agent which reduces inflammation and enhances fibroplasia, epithelization and angiogenesis in the presence of growth factors. 20 New Zealand type female rabbits were used. They were divided into two groups, each consisting of ten rabbits. The brass comb, which had gained adequate heat in boiling water for 15 minutes, pressed onto each rabbit's right auricula for 20 seconds to burn them in a pattern. Single dose of autogenous PRP was injected to stasis zone of experimental group while saline at the same amount was injected to sham group. After 72 hours of burn trauma; scintigraphic examination was carried out. Subsequently, rabbits' burnt ears were excised for immunohistochemistry assay. Histopathologic examination of reepithelization, neutrophil infiltration, fibroblast proliferation, angiogenesis and macrophage density were performed and apoptotic ratios were measured. Stasis zone area was also calculated by using the programme Image J for photoanalysis. The results were evaluated by Mann Whitney U and student-T tests. In the experimental group the vital areas of salvaged stasis zone, reepithelization, neutrophil infiltration, fibroblast proliferation and apoptotic ratios were statistically significant compared to sham group. Application of PRP on stasis zone has shown advanced anti-apoptotic and anti-inflammatory effects in acute burn. In salvage of stasis zone, PRP had maintained considerable epithelial and connective tissue regeneration. In conclusion, PRP treatment is significantly effective in salvage of stasis zone by preventing the destructive effects of inflammation and decreasing apoptosis. PRP will take part in clinical practice after evaluating with further studies. Keywords: Burn, stasis zone, PRP