Acceleration of Full-thickness Wound Healing in Porcine Model by Autologous Platelet Gel

Controversy over efficacy of many wound treatments, particularly autologous platelet gel (APG), is common. The objective of this study was to determine if autologous platelet gel would accelerate the healing process of full-thickness cutaneous wounds in a porcine model. Autologous platelet gel with a ratio of 10:4 was created using 10 cc platelet-rich plasma and 4 cc autologous thrombin rich plasma. A punch was used to create 24 full-thickness, cutaneous round wounds on each flank of a neutered pig and were treated with APG on 1 side versus 0.9% saline (control) on the other side. The wounds were then covered with transparent vapor permeable film dressing. On Day 14 and Day 28 post-injury, all 24 wounds were photographed and digital imaging system tracings determined the area of each wound. Biopsy specimens from each wound were obtained. On Day 14, the specimens were taken from 9- and 3 o'clock positions at the edge of the round wounds, and on Day 28 the specimens were taken from 12- and 6 o'clock positions of the round wounds. This was done to reduce bias from variations in thickness of the pig skin. Sections were stained with hematoxylin and eosin for histological study, which included microscopic review and dermal thickness measurement. The mean size of wounds treated with APG was consistently smaller than contralateral wounds treated with saline alone. On Days 14 and 28 post-injury, APG-treated wounds were 23% and 25% smaller in area than the control wounds (P < 0.001), respectively. Histological study revealed thicker dermis on APG-treated wounds and more normal anatomic skin structures on the APG side. Higher magnification revealed leukocytes consistently more prevalent in granulation tissue on the control side, indicating a delayed healing process.