Dr Alexandra Schulz1, Professor Dr Paul Christian Fuchs1, Dr Wolfram Heitzmann1, Dr Jennifer Lynn Schiefer1
1Department of Plastic Surgery, Cologne Merheim Medical Center, University of Witten Herdecke, Cologne, Germany
Enzymatic debridement was found to remove burn eschar selectively. Thus, vital tissue can be preserved and burn wounds can heal spontaneously in many cases. However, healing time can be significantly prolonged depending on burn depth and extend. It is therefore questionable, whether the application of Platelet Rich Fibrin (PRF) can shorten the wound healing time and thus improve long term scar quality.
In a single-centre clinical trial we treated patients with partial thickness to deep dermal burns by enzymatic debridement followed by PRF application. All patients wear compression clothing over 6 months. After 8 and 12 months, the aesthetics and function of the scar were assessed objectively and subjectively.
30 patients (age min16 years, max 70 years; TBSA min 1%, max 35%) with partial thickness to deep dermal burns (among them 10 facial burns) were included in the study. Between 0.5% and 9% burn surface was treated enzymatically followed by PRF application. PRF preparation and application was easy to learn even for unexperienced users with some device related issues in the early stage of their learning curve. Patients reported minor pain during procedure without additional anaesthesia. No adverse occurred during any treatment. It was found that by adding PRF, wound healing time could be reduced. We found excellent results in scaring after 8 and 12 months.
The treatment of partial thickness to deep dermal burns with PRF following enzymatic debridement might be suitable to improve wound healing, scar quality and the functionality of the hand after burn injury. The treatment is easy to handle and patients tolerate the treatment well.
Dr. Alexandra Schulz is a private lecturer at the University of Witten/Herdecke and a specialist in Plastic Surgery. She is working since many years in burn reserach with a special focus on enzymatic debridement and burn wound treatment.