Abstract

Platelet rich plasma is known for its hemostatic, adhesive and healing properties due to the many growth factors released from the platelets into the wound site. Autologous PRP helps to achieve stable hemostasis as it mimics the final stages of the clotting cascade. It adheres to the bed grafts immediately to prevent any collection under the graft or undue shear.(1,2)Decreased production and release, entrapment, degradation or combination of these mechanisms can lead to a decreased growth factors in chroniculcers that delay wound healing, which can be overcome by PRP.(3,4 ) Factors affecting graft take include shearing of graft, contaminated or poorly vascularised bed, seroma/ hematoma formation, co morbid conditions and smoking. Graft take is decreased in structures with decreased blood supply such as cartilage, bone and tendon. Wound bed should be vascular, free of streptococcal infection, pus. The success of skin graft depends on , haemostasis and adhesion of skin graft to wound bed, local vascularity, wound microbiology. Hemostasis can be achieved by applying epinephrine socks to the wound bed application to application of skin grafts, but with local and systemic side effects.(5) While normal platelets are approximately 1,50,000 to 4,50,000 / cubic mm in the blood, platelet rich plasma (PRP) has a higher platelet ratio than baseline compared to the same volume of whole blood. Growth factors in PRP promote angiogenesis, collagen synthesis and epithelisation, reduce dermal scarring and facilitate remodelling.(6) Skin graft is conventionally fixed to wound margins with sutures, staplers, cyano acrylate glue or fibrin glue and quilted to the wound bed in order to prevent shearing and seroma under the graft. However, these methods added to the operating time and cost.’ (7,8)As it mimics the last steps of coagulation cascade Autologous PRP helps achieve stable haemostasis

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